MEDICARE: AURORA ALEJANDRA GOMEZ SELPIDES MD, MPH

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	207Q00000X	Family Medicine Physician	R74392	AZ
2	207Q00000X	Family Medicine Physician	148911	CA

General Provider Information

NPI Number	:	1922413673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AURORA ALEJANDRA GOMEZ SELPIDES MD, MPH

Provider Business Mailing Address
First Line	:	2240 MERCURY WAY
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407-5413
Country	:	US
Telephone Number	:	707-566-6302
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 MERCURY WAY
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407-5413
Country	:	US
Telephone Number	:	707-566-6302
Fax Number	:

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

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	01/10/2022

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