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NPI Code Detail

MEDICARE: GINA MARIE GONZALES

MEDICARE: GINA MARIE 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
1156FX1800XOpticianCA

General Provider Information

NPI Number : 1730045204
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA MARIE GONZALES
Provider Business Mailing Address
First Line : 1801 WESTWIND DR
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-3028
Country : US
Telephone Number : 661-632-1846
Fax Number : 661-632-1878
Provider Business Practice Location Address
First Line : 1801 WESTWIND DR
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-3028
Country : US
Telephone Number : 661-632-1846
Fax Number : 661-632-1878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2025
Last Update Date : 12/29/2025

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