# HENRY J GONZALEZ M D INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831459015
- **Authorized official:** HENRY J GONZALEZ M.D. (PRESIDENT)
- **Authorized official phone:** (909) 985-2112

## Contact information

- **Practice address:** 999 SAN BERNARDINO RD, UPLAND, CA 91786-4920
- **Practice address phone:** (909) 985-2811
- **Mailing address:** PO BOX 148, CLAREMONT, CA 91711-0148
- **Mailing address phone:** (909) 985-2112
- **Mailing address fax:** (909) 985-3411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | G56342 | CA | — |
| 208D00000X | General Practice Physician | G56342 | CA | Yes |

## Other

- **Enumeration date:** 05/22/2012
- **Last updated:** 05/22/2012