Healthcare Provider Details

I. General information

NPI: 1316407364
Provider Name (Legal Business Name): ARIEL BRITO GONZALEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2019
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 BEAR MOUNTAIN BLVD
ARVIN CA
93203-1231
US

IV. Provider business mailing address

1305 BEAR MOUNTAIN BLVD
ARVIN CA
93203-1231
US

V. Phone/Fax

Practice location:
  • Phone: 618-543-1316
  • Fax: 661-854-2689
Mailing address:
  • Phone: 618-543-1316
  • Fax: 661-854-2689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPTL71
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA178301
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: