MEDICARE: ABIGAIL F GONZALEZ L.AC.

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
1	171100000X	Acupuncturist	AC11290	CA

General Provider Information

NPI Number	:	1306967997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL F GONZALEZ L.AC.

Provider Business Mailing Address
First Line	:	6475 E PACIFIC COAST HWY
Second Line	:	119
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4201
Country	:	US
Telephone Number	:	562-508-5975
Fax Number	:	562-430-8591

Provider Business Practice Location Address
First Line	:	6557 E PACIFIC COAST HWY # H-10
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4202
Country	:	US
Telephone Number	:	562-430-8501
Fax Number	:	562-430-8591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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