Individual
GEOFFREY GONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27401 LOS ALTOS, 180, MISSION VIEJO, CA 92691-6316
(949) 582-9624
(949) 582-9624
Mailing address
27401 LOS ALTOS, 180, MISSION VIEJO, CA 92691-6316
(949) 582-9624
(949) 582-9624
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G79480
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G794800
—
CA
Enumeration date
05/22/2006
Last updated
01/25/2008
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