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NPI Code Detail

MEDICARE: MICHAEL GOMEZ RN

MEDICARE: MICHAEL GOMEZ RN
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
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse95396687CA

General Provider Information

NPI Number : 1548114986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL GOMEZ RN
Provider Business Mailing Address
First Line : 10898 BOESSOW RD
Second Line :
City : GALT
State : CA
Zip : 95632-8451
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10898 BOESSOW RD
Second Line :
City : GALT
State : CA
Zip : 95632-8451
Country : US
Telephone Number : 925-505-7187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2026
Last Update Date : 02/23/2026

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