Individual
ERNESTO GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3427 4TH AVE, SAN DIEGO, CA 92103-4910
(619) 525-9903
Mailing address
3427 4TH AVE, SAN DIEGO, CA 92103-4910
(619) 525-9903
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/22/2019
Last updated
11/22/2019
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