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NPI Code Detail

MEDICARE: LOIDA GONZALES

MEDICARE: LOIDA 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
1183500000XPharmacist56787CA

General Provider Information

NPI Number : 1679858450
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOIDA GONZALES
Provider Business Mailing Address
First Line : 8400 ELK GROVE FLORIN RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95624-9450
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8400 ELK GROVE FLORIN RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95624-9450
Country : US
Telephone Number : 916-525-3563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2011
Last Update Date : 10/12/2011

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Directions to “ LOIDA GONZALES ” Practice Location

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