Individual
BENJAMIN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
400 N PEPPER AVE # 205, COLTON, CA 92324-1801
(909) 580-1775
Mailing address
400 N PEPPER AVE # 205, COLTON, CA 92324-1801
(909) 580-3390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61704
CA
Other
Enumeration date
06/23/2022
Last updated
04/11/2024
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