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NPI Code Detail

MEDICARE: MR. JOSE GONZALEZ

MEDICARE: MR. JOSE GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist7077CA

General Provider Information

NPI Number : 1124220496
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSE GONZALEZ
Provider Business Mailing Address
First Line : 1014 ALLEN AVE APT 3
Second Line :
City : GLENDALE
State : CA
Zip : 91201-1653
Country : US
Telephone Number : 818-843-3777
Fax Number : 818-843-0065
Provider Business Practice Location Address
First Line : 804 S VICTORY BLVD
Second Line :
City : BURBANK
State : CA
Zip : 91502-2427
Country : US
Telephone Number : 818-843-3777
Fax Number : 818-843-0065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 07/08/2007

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Directions to “ MR. JOSE GONZALEZ ” Practice Location

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