Individual
MICHAEL JOSE GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4640 ADMIRALTY WAY STE 420, MARINA DEL REY, CA 90292-6617
(424) 526-5151
(424) 835-6475
Mailing address
14153 VICTORY BLVD APT 212, VAN NUYS, CA 91401-1941
(847) 736-5183
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
296722
CA
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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