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Individual

RENE GONZALEZ GARCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1957 HWAY 95 STE 23, BULLHEAD CITY, AZ 86442-6744
(928) 234-3834
(602) 792-7270
Mailing address
PO BOX 90182, HENDERSON, NV 89009-0182
(928) 293-5999

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
587
PR
207Q00000X
Family Medicine Physician
4301117103
MI
208D00000X
General Practice Physician
15953
PR
208D00000X
General Practice Physician
Primary
4301117103
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DJ664A
MEDICARE
PR
Enumeration date
10/15/2006
Last updated
03/02/2023
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