Individual
GUSTAVO VIRGEN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SAN FERNANDO RD, SAN FERNANDO, CA 91340-3115
(818) 896-0531
Mailing address
11038 CAMARILLO ST UNIT 7, TOLUCA LAKE, CA 91602-3542
(818) 523-4079
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A96103
CA
Other
Enumeration date
06/25/2008
Last updated
12/03/2021
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