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General NPI Number Information
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NPI Number | 1356022321
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Entity Type | Individual
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Provider Name | ALBERTO GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 679 S NEW HAMPSHIRE AVE STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90005-1355
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Country | US
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Telephone | 626-776-4595
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Fax |
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Provider Business Mailing Address
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Address Line | 215 S ROSCOMMON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90022-1719
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Country | US
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Telephone | 323-542-4757
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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