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Individual
DR. MICHAEL GOMENDOZA
Active
Individual
DR. MICHAEL GOMENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036094737
IL
207R00000X
Internal Medicine Physician
Primary
40250
IA
207RP1001X
Pulmonary Disease Physician
036094737
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094737
—
IL
01
—
110180747
RAILROAD MEDICARE
—
Enumeration date
08/18/2006
Last updated
12/22/2016
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