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General NPI Number Information
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NPI Number | 1639194848
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Entity Type | Individual
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Provider Name | RAFAEL GONZALEZ-AMADO MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 210 E GRAND AVE
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-4811
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Country | US
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Telephone | 610-551-2740
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Fax |
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Provider Business Mailing Address
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Address Line | FILE #55737
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City | LOS ANGELES
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State | CA
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Zip | 90074
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Country | US
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Telephone | 310-301-8708
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Fax | 310-301-8751
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A51030
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License Number State | CA
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