Individual
ORLANDO GONZALEZ GOMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(208) 885-6111
Mailing address
76 GALLEON WAY, PITTSBURG, CA 94565-3539
(925) 395-8675
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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