Individual
NICHOLAS GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
365 HAWTHORNE AVE STE 101, OAKLAND, CA 94609-3115
(510) 465-5523
Mailing address
365 HAWTHORNE AVE STE 101, OAKLAND, CA 94609-3115
(510) 465-5523
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A163255
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2017
Last updated
07/30/2026
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