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Individual

MR. GEORGE GONZALEZ

Active
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Individual

MR. GEORGE GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G55847
CA
207V00000X
Obstetrics & Gynecology Physician
G55847
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G558470
BLUE CROSS/BLUE SHIELD
CA
05
—
00G558470
—
CA
01
—
110125078
RAILROAD MEDICARE
CA
01
—
77040368493612B010
CHAMPUS
CA
Enumeration date
11/10/2005
Last updated
06/02/2020
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