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General NPI Number Information
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NPI Number | 1639276520
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Entity Type | Individual
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Provider Name | LUIS L GONZALEZ JR. MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 8300 E DIXILETA DR #278
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City | SCOTTSDALE
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State | AZ
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Zip | 85266-2273
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Country | US
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Telephone | 602-770-2468
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Fax | 480-409-2512
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Provider Business Mailing Address
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Address Line | PO BOX 28757
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-0162
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Country | US
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Telephone | 602-770-2468
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Fax | 480-409-2512
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 15447
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License Number State | AZ
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