Healthcare Provider Details

I. General information

NPI: 1962073254
Provider Name (Legal Business Name): AMY GOZALEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21810 NORMANDIE AVE FL 2
TORRANCE CA
90502-2047
US

IV. Provider business mailing address

21810 NORMANDIE AVE FL 2
TORRANCE CA
90502-2047
US

V. Phone/Fax

Practice location:
  • Phone: 310-533-6600
  • Fax: 310-347-4457
Mailing address:
  • Phone: 310-533-6600
  • Fax: 310-347-4457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: