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General NPI Number Information
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NPI Number | 1669635785
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Entity Type | Individual
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Provider Name | MICHAEL RAYMUND C GONZALES MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 10085 DOUBLE R BLVD STE 310
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City | RENO
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State | NV
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Zip | 89521-4832
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Country | US
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Telephone | 775-982-7260
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Fax | 775-982-7268
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Provider Business Mailing Address
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Address Line | 850 HARVARD WAY
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City | RENO
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State | NV
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Zip | 89502-2055
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Country | US
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Telephone | 518-253-0772
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Fax | 775-982-5496
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 21747
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 309848
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116019889
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 16309
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License Number State | NV
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