Organization
ADALBERTO C. GONZALEZ, M.D., PROF. CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADALBERTO C GONZALEZ MD (CEO)
(623) 399-8606
Entity
Organization
Contact information
Practice address
5333 N 7TH ST, SUITE B219, PHOENIX, AZ 85014-2821
(602) 881-5430
(623) 399-8606
Mailing address
3219 E CAMELBACK RD, #833, PHOENIX, AZ 85018-2307
(602) 881-5430
(623) 399-8606
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
12521
AZ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
12521
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12521
AZ LICENSE #
AZ
Enumeration date
08/17/2011
Last updated
08/17/2011
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