MEDICARE: DR. FORTUNATA NARVAEZ GOZUN M.D.

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
1	207Q00000X	Family Medicine Physician	MD-9583	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225126741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FORTUNATA NARVAEZ GOZUN M.D.

Provider Business Mailing Address
First Line	:	91-6390 KAPOLEI PKWY STE 200
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706
Country	:	US
Telephone Number	:	808-691-8200
Fax Number	:	808-677-1372

Provider Business Practice Location Address
First Line	:	91-6390 KAPOLEI PKWY STE 200
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706
Country	:	US
Telephone Number	:	808-691-8200
Fax Number	:	808-677-1372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/04/2020

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