Physician Compare National (NPI:1760685234)

HEALTHCARE PROVIDER: GONZALO CORONA-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	1760685234
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9537346614
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110527000546
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CORONA-GONZALEZ
	Individual professional last name
Provider First Name	GONZALO
	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	1986
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PEDIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	304 S LEA AVE
	Group Practice or individual's line 1 address
City	ROSWELL
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	882034562
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	320006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EASTERN NEW MEXICO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y