Individual
GUILLERMO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
196 UNION ST, NEW BEDFORD, MA 02740-5942
(508) 990-4963
(508) 990-4964
Mailing address
PO BOX 3021, NEW BEDFORD, MA 02741-3021
(508) 990-4963
(508) 990-4964
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
59703
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003490
BEACON
MA
05
—
110055741A
—
MA
05
—
3137988
—
MA
Enumeration date
08/02/2005
Last updated
10/04/2011
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