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NPI Code Detail

MEDICARE: OLGA LYDIA GONZALEZ MD

MEDICARE:   OLGA LYDIA GONZALEZ  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianG077811CA

General Provider Information

NPI Number : 1063510063
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLGA LYDIA GONZALEZ MD
Provider Business Mailing Address
First Line : 2145 5TH AVE
Second Line :
City : OROVILLE
State : CA
Zip : 95965-5870
Country : US
Telephone Number : 530-751-8454
Fax Number : 530-751-8456
Provider Business Practice Location Address
First Line : 1231 PLUMAS ST
Second Line :
City : YUBA CITY
State : CA
Zip : 95991-3410
Country : US
Telephone Number : 530-751-8454
Fax Number : 530-751-8456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 08/02/2016

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Directions to “ OLGA LYDIA GONZALEZ MD” Practice Location

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