Individual
TAYLOR GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNIM
Contact information
Practice address
9811 W CHARLESTON BLVD # 2-641, LAS VEGAS, NV 89117-7528
(855) 864-4322
(888) 315-4512
Mailing address
4228 N 44TH PL, PHOENIX, AZ 85018-4305
(205) 706-5505
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
2988
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2988
CNIM
—
Enumeration date
06/10/2013
Last updated
08/18/2015
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