Individual
DR. DAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 N CENTRAL AVE, PHOENIX, AZ 85004-1646
(602) 256-2124
Mailing address
44 W MONROE ST APT 2105, PHOENIX, AZ 85003-4599
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019454
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S019454
PHARMACY STATE LICENSE
—
Enumeration date
06/10/2014
Last updated
06/10/2014
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