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General NPI Number Information
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NPI Number | 1265958862
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Entity Type | Organization
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Legal Business Name | RICARDO GONZALEZ MD FAMILY PRACTICE PC
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2005 SIERRA HIGHLANDS DR STE 101
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City | RENO
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State | NV
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Zip | 89523-2301
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Country | US
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Telephone | 775-624-6492
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 SIERRA HIGHLANDS DR STE 101
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City | RENO
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State | NV
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Zip | 89523-2301
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Country | US
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Telephone | 775-624-6492
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICARDO J. GONZALEZ
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Credential | MD
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Telephone | 775-624-6492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 10279
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10279
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License Number State | NV
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