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General NPI Number Information
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NPI Number | 1497910137
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Entity Type | Organization
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Legal Business Name | YOLANDA P. GOMEZ, M.D., INC.
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 29941 AVENTURA SUITE G
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2015
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Country | US
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Telephone | 949-713-9705
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Fax |
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Provider Business Mailing Address
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Address Line | 29941 AVENTURA SUITE G
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2015
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Country | US
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Telephone | 949-713-9705
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YOLANDA PATRICIA GOMEZ
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Credential | M.D.
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Telephone | 949-713-9705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | C50624
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License Number State | CA
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