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General NPI Number Information
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NPI Number | 1457038689
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Entity Type | Organization
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Legal Business Name | BRIAN GONZALES CHIROPRACTIC INC
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 2200 HAMNER AVE STE 100
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City | NORCO
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State | CA
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Zip | 92860-2673
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Country | US
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Telephone | 951-805-3077
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Fax | 951-278-4436
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Provider Business Mailing Address
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Address Line | 2200 HAMNER AVE STE 100
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City | NORCO
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State | CA
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Zip | 92860-2673
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Country | US
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Telephone | 951-805-3077
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Fax | 951-278-4436
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN P GONZALES
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Credential | DS
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Telephone | 951-805-3077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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