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NPI Code Detail

MEDICARE: LOUIE GONZALES

MEDICARE: LOUIE GONZALES
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1649989492
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUIE GONZALES
Provider Business Mailing Address
First Line : 12580 LAKELAND RD
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-3940
Country : US
Telephone Number : 562-213-5735
Fax Number :
Provider Business Practice Location Address
First Line : 12580 LAKELAND RD
Second Line :
City : SANTA FE SPRINGS
State : CA
Zip : 90670-3940
Country : US
Telephone Number : 562-213-5735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2022
Last Update Date : 11/21/2022

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Directions to “ LOUIE GONZALES ” Practice Location

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