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Organization
MANUEL D GONZALEZ, O.D., INC
Active
Organization
MANUEL D GONZALEZ, O.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL D GONZALEZ O.D. (PRESIDENT)
(562) 868-2418
Entity
Organization
Contact information
Practice address
11552 TELEGRAPH RD, SANTA FE SPRINGS, CA 90670-3110
(562) 868-2418
(562) 868-7043
Mailing address
11552 TELEGRAPH RD, SANTA FE SPRINGS, CA 90670-3110
(562) 868-2418
(562) 868-7043
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7199 TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0071990
—
CA
Enumeration date
02/22/2012
Last updated
02/22/2012
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