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General NPI Number Information
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NPI Number | 1669936209
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Entity Type | Individual
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Provider Name | HECTOR ALBERTO GONZALEZ MS, ATC
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Gender | Male
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 1801 PANORAMA DR
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City | BAKERSFIELD
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State | CA
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Zip | 93305-1219
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Country | US
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Telephone | 818-447-7515
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Fax |
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Provider Business Mailing Address
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Address Line | 12158 BUCKEYE AVE
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City | SYLMAR
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State | CA
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Zip | 91342-5240
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Country | US
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Telephone | 818-447-7515
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000038696
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License Number State | CA
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