Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A132475 | CA |
NPI | 1336408194 |
---|---|
Provider Name | Evelyn L Gomez |
First Address | Hanford, CA 93230-6644 |
Second Address | Hanford, CA 93230-6644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2012 |
Last Update Date | 11/09/2015 |