Healthcare Provider Details

I. General information

NPI: 1356476410
Provider Name (Legal Business Name): MANUEL FALCON GONZALES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 19TH ST NW SUITE 850
WASHINGTON DC
20036-3701
US

IV. Provider business mailing address

6212 STONEHAM LN
MCLEAN VA
22101-2343
US

V. Phone/Fax

Practice location:
  • Phone: 202-223-9040
  • Fax:
Mailing address:
  • Phone: 703-442-9079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD 6405
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD 6405
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: