Individual
CHRISTOPHER GONZAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2111 COLLEGE DR, REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, GALLUP, NM 87301-5600
(505) 863-1820
Mailing address
1901 REDROCK DR, PFS DEPT, GALLUP, NM 87301-5683
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
97-60
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002252
LOVELACE HEALTH/SALUD
NM
01
—
110154015
RAILROAD MEDICARE
—
01
—
201014111
PRESBYTERIAN HEALTH/SALUD
NM
05
—
386319
—
AZ
01
—
85031326887301A175
CHAMPUS
—
01
—
NM004423
BC/BS
NM
01
—
PROVP12658
MOLINA
NM
05
—
Q2353
—
NM
Enumeration date
01/09/2006
Last updated
07/08/2007
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