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Individual

DR. ERIC GABRIEL GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
616 E SOUTHERN AVE, #103, MESA, AZ 85204
(602) 569-3999
(602) 569-3887
Mailing address
1533 E WILLETTA ST, PHOENIX, AZ 85006-2935
(602) 569-3999
(602) 569-3887

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
18622
PR
208000000X
Pediatrics Physician
Primary
51791
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120323
AZ
Enumeration date
07/26/2010
Last updated
08/23/2019
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