Healthcare Provider Details

I. General information

NPI: 1639759210
Provider Name (Legal Business Name): ALYSSA KARINA GONZALEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3298
US

IV. Provider business mailing address

3800 W CHAPMAN AVE STE 3400
ORANGE CA
92868-1616
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8224
  • Fax:
Mailing address:
  • Phone: 714-456-8224
  • Fax: 714-456-8360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA194720
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: