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Individual
LAUREN B GONZALEZ
Active
Individual
LAUREN B GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14175 TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT14175
CA STATE LICENSE
CA
Enumeration date
08/11/2011
Last updated
01/14/2013
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