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General NPI Number Information
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NPI Number | 1518164029
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Entity Type | Individual
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Provider Name | MRS. YOLANDA G GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1526 N EDGEMONT ST
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City | LOS ANGELES
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State | CA
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Zip | 90027-5260
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Country | US
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Telephone | 323-783-4954
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Fax |
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Provider Business Mailing Address
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Address Line | 5034 CHERRY CREEK SOUTH DR
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City | DENVER
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State | CO
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Zip | 80246-2290
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Country | US
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Telephone | 303-756-1788
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Fax | 303-759-1788
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6721
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9233
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License Number State | CO
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