Individual
ANGEL R GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 E BASELINE RD, PHOENIX, AZ 85042-6510
(602) 824-4352
(602) 824-4259
Mailing address
325 E BASELINE RD, PHOENIX, AZ 85042-6510
(602) 824-4352
(602) 824-4259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29250
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
584533
—
AZ
01
—
AZ0206250
BLUE CROSS/BLUE SHIELD
AZ
Enumeration date
05/05/2006
Last updated
01/25/2011
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