Physician Compare National (NPI:1659512309)

HEALTHCARE PROVIDER: RENE GONZALEZ MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659512309
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183771207
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090407000377
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GONZALEZ
	Individual professional last name
Provider First Name	RENE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ADDICTION MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	GERIATRIC PSYCHIATRY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ADDICTION MEDICINE, GERIATRIC PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	PAIN AND ADDICTION SERVICES LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2365795937
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1110 PENNSYLVANIA ST NE B
	Group Practice or individual's line 1 address
City	ALBUQUERQUE
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	871107404
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5057502034
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y