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General NPI Number Information
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NPI Number | 1457074650
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Entity Type | Individual
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Provider Name | NICHOLAS CRUZ GOMEZ DC
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Gender | Male
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 16686 ROAD 168
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City | WOODVILLE
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State | CA
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Zip | 93257-9246
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Country | US
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Telephone | 559-686-9097
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 E CARTMILL AVE
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City | TULARE
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State | CA
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Zip | 93274-9610
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Country | US
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Telephone | 559-631-4042
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 36446
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License Number State | CA
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