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General NPI Number Information
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NPI Number | 1134064504
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Entity Type | Organization
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Legal Business Name | DIEGO GONZALEZ MD PC
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 4630 JEFFERSON LANE NE SUITE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87109
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Country | US
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Telephone | 505-633-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 WYOMING BLVD NE SUITE M4 #308
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City | ALBUQUERQUE
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State | NM
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Zip | 87113
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DIEGO J GONZALEZ
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Credential | MD
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Telephone | 505-250-8337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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