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General NPI Number Information
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NPI Number | 1346265873
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Entity Type | Individual
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Provider Name | LUIS A GONZALEZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 803 FIGUEROA ST
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City | WILMINGTON
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State | CA
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Zip | 90744-2300
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Country | US
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Telephone | 310-830-0863
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Fax | 310-830-6969
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Provider Business Mailing Address
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Address Line | 803 FIGUEROA ST
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City | WILMINGTON
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State | CA
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Zip | 90744-2300
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Country | US
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Telephone | 310-830-0863
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Fax | 310-830-6969
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 29860
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC29860
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number | 998706
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License Number State | CA
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