Individual
GABRIEL ISAZA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-2191
(215) 214-3992
Mailing address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-2191
(215) 214-3992
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD471112
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2016
Last updated
09/09/2020
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