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NPI Code Detail

MEDICARE: ANTHONY GONZALEZ

MEDICARE: ANTHONY 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 : 1760507347
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY GONZALEZ
Provider Business Mailing Address
First Line : 6736 LAUREL CANYON BLVD STE 200
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-1576
Country : US
Telephone Number : 818-755-8786
Fax Number : 818-755-8789
Provider Business Practice Location Address
First Line : 6736 LAUREL CANYON BLVD STE 200
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-1576
Country : US
Telephone Number : 818-755-8786
Fax Number : 818-755-8789
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 12/23/2013

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