Healthcare Provider Details

I. General information

NPI: 1750299723
Provider Name (Legal Business Name): ANGEL GONZALEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

798 LIGHTHOUSE AVE # 324
MONTEREY CA
93940-1010
US

IV. Provider business mailing address

1002 WALNUT AVE APT 232
GREENFIELD CA
93927-4965
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 831-260-7765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: