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General NPI Number Information
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NPI Number | 1902830060
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Entity Type | Individual
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Provider Name | AIMEE GONZALEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 529 PINE AVE
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City | HOLTVILLE
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State | CA
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Zip | 92250-1121
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Country | US
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Telephone | 760-756-3112
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Fax | 760-545-0257
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Provider Business Mailing Address
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Address Line | 125 S 5TH ST SUITE 2
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City | BRAWLEY
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State | CA
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Zip | 92227-2408
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Country | US
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Telephone | 760-344-8100
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Fax | 760-545-0243
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C51815
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License Number State | CA
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