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General NPI Number Information
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NPI Number | 1538215900
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Entity Type | Individual
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Provider Name | TERESA R. GONZALEZ RPA-C
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD RM 2C156
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City | TRIPLER AMC
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 808-433-1946
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Fax | 808-207-2553
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Provider Business Mailing Address
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Address Line | 91-1007 WAIILIKAHI ST
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City | EWA BEACH
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State | HI
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Zip | 96706-6407
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Country | US
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Telephone | 917-582-2356
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Fax | 808-207-2553
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | AMD1456
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 009531
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License Number State | NY
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