Individual
DARRELL WAYNE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9850 GENESEE AVE, SUITE 500, LA JOLLA, CA 92037-1224
(858) 657-0267
Mailing address
9850 GENESEE AVE, SUITE 500, LA JOLLA, CA 92037-1224
(858) 657-0267
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A88738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346488004
GROUP NPI
—
01
—
A88738
MEDICAL LICENSE
CA
Enumeration date
08/14/2006
Last updated
05/13/2009
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