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Organization
GONZALES MEDICAL GROUP INC
Active
Organization
GONZALES MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE CARMEN PONZIO MD (MEDICAL DOCTOR)
(831) 675-3601
Entity
Organization
Contact information
Practice address
133 FOURTH STREET, GONZALES, CA 93926
(831) 675-3601
(831) 675-3966
Mailing address
PO BOX 646, 133 FOURTH STREET, GONZALES, CA 93926-0646
(831) 675-3601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G48377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7032530
—
CA
05
—
RHM53884G
—
CA
Enumeration date
05/18/2007
Last updated
12/07/2007
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