MEDICARE: NORA LUZ 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
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1639562689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORA LUZ GONZALEZ

Provider Business Mailing Address
First Line	:	3609 10TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4114
Country	:	US
Telephone Number	:	323-298-3680
Fax Number	:	213-402-3551

Provider Business Practice Location Address
First Line	:	3609 10TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4114
Country	:	US
Telephone Number	:	323-298-3680
Fax Number	:	213-402-3551

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

Provider Enumeration Date	:	03/16/2015
Last Update Date	:	11/04/2025

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