NPI Code Detail JSON Logo

1215814900 NPI number — ANDRES GONZALEZ

NPI Number: 1215814900
Health Care Provider/Practitioner: ANDRES GONZALEZ

Information about “1215814900” NPI (ANDRES GONZALEZ) exists in 1215814900 in HTML format HTML  |  1215814900 in plain Text format TXT  |  1215814900 in PDF (Portable Document Format) PDF  |  1215814900 in an XML format XML  formats.

NPI Number : 1215814900 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215814900",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GONZALEZ",
    "FirstName": "ANDRES",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 430671",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN YSIDRO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92143-0671",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "664-421-0452",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1245 7TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WASCO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93280-1820",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-758-3021",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/16/2025",
    "LastUpdateDate": "09/12/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "112254",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.