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Individual
DR. MARIO H GOMEZ
Active
Individual
DR. MARIO H GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
0101042524
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945557
—
VA
05
—
007172966
—
VA
01
—
036579003
MAGELLAN
VA
01
—
267418
MAMSI
VA
01
—
381732
ANTHEM - POWH LOC
VA
01
—
451731
ANTHEM - GCH LOC
VA
01
—
A932442
VALUE OPTIONS
VA
01
—
O89172
SENTARA
VA
Enumeration date
06/02/2006
Last updated
05/13/2008
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