Individual
JEFFREY GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2379 S MIRA CT UNIT 200, ANAHEIM, CA 92802-5513
(714) 422-6212
Mailing address
2379 S MIRA CT UNIT 200, ANAHEIM, CA 92802-5513
(714) 422-6212
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9668
CA
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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