Individual
MR. NATHAN GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
80B VETERANS BLVD, ACL IHS, ACOMA, NM 87034
(505) 552-5385
(505) 552-5828
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5385
(505) 552-5828
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
07001577
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
07/23/2013
Last updated
07/23/2013
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