Enrique Jose Gonzalez
General Practice Physician
321 S Mednik Ave
Los Angeles
, California 90022
Enrique Jose Gonzalez
General Practice Physician
321 S Mednik Ave
Los Angeles
, California 90022
(323) 261-4124
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Enrique Jose Gonzalez
- 321 S Mednik Ave
- Los Angeles, CA
- Zip : 90022-1839
- Fax : (323) 261-4124
- Phone : (323) 261-4706
Second Address
- Enrique Jose Gonzalez
- 321 S Mednik Ave
- Los Angeles, CA
- Zip : 90022
- Fax : (323) 261-4124
- Phone : (323) 261-4706
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | G74790 | CA |
National Provider Identifier
| NPI | 1023161684 |
|---|---|
| Provider Name | Enrique Jose Gonzalez |
| First Address | Los Angeles, CA 90022-1839 |
| Second Address | Los Angeles, CA 90022 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/01/2007 |
| Last Update Date | 05/03/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| F89575 | (02) | CA |
| G747490 | (05) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.