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NPI Code Detail

MEDICARE: SAUL O GONZALEZ

MEDICARE: SAUL O GONZALEZ
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1588794804
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAUL O GONZALEZ
Provider Business Mailing Address
First Line : 14233 FOOTHILL BLVD
Second Line : 6
City : SYLMAR
State : CA
Zip : 91342-7590
Country : US
Telephone Number : 818-364-7571
Fax Number :
Provider Business Practice Location Address
First Line : 6305 WOODMAN AVE
Second Line :
City : VAN NUYS
State : CA
Zip : 91401-2346
Country : US
Telephone Number : 818-908-4999
Fax Number : 818-904-0176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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Directions to “ SAUL O GONZALEZ ” Practice Location

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