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General NPI Number Information
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NPI Number | 1225858509
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Entity Type | Individual
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Provider Name | JOSHUA DAVID JOHN GOMEZ-CASTRO RN
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Gender | Male
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 1303 E HERNDON AVE
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City | FRESNO
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State | CA
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Zip | 93720-3309
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Country | US
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Telephone | 559-450-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 LOMA VISTA PKWY APT 3903
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City | CLOVIS
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State | CA
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Zip | 93619-9861
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Country | US
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Telephone | 805-602-0879
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 95322885
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License Number State | CA
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