MEDICARE: GONZALO A CAZAS 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	207L00000X	Anesthesiology Physician	A43494	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00175242	OTHER	CA	RAILROAD MEDICARE

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	:	1790902708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GONZALO A CAZAS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 788
Second Line	:
City	:	HEMET
State	:	CA
Zip	:	92546-0788
Country	:	US
Telephone Number	:	951-929-6260
Fax Number	:

Provider Business Practice Location Address
First Line	:	28400 MCCALL BLVD
Second Line	:
City	:	SUN CITY
State	:	CA
Zip	:	92585-9658
Country	:	US
Telephone Number	:	951-929-6260
Fax Number	:

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	12/21/2012

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