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General NPI Number Information
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NPI Number | 1306379508
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Entity Type | Individual
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Provider Name | TARA JEAN GONZALEZ MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 3451 E 12TH ST
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City | OAKLAND
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State | CA
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Zip | 94601-3463
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Country | US
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Telephone | 510-535-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 POTRERO AVE BLDG 80 SFGH FAMILY HEALTH CENTER
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3518
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Country | US
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Telephone | 415-206-5252
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A158829
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License Number State | CA
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