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General NPI Number Information
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NPI Number | 1821670068
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Entity Type | Individual
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Provider Name | MARIA ISABEL GONZAGA MD
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Gender | Female
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1100 N STATE STREET CT-A-7-D
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-409-6931
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Fax | 323-441-8185
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Provider Business Mailing Address
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Address Line | 1100 N STATE STREET CT-A-7-D
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-409-6931
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Fax | 323-441-8185
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | BP10075331
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A202791
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License Number State | CA
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