Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | C162154 | CA |
Y | 208600000X | Surgeon | C162154 | CA |
N | 2086S0129X | Vascular Surgeon | 275512 | NY |
NPI | 1144452186 |
---|---|
Provider Name | Dr. Lorena Gonzalez |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Duarte, CA 91010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2009 |
Last Update Date | 15/12/2020 |