Individual
RENE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4808
(505) 750-2034
Mailing address
707 BROADWAY BLVD NE STE 500, ALBUQUERQUE, NM 87102-2367
(505) 232-9055
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
86-234
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22605304
—
NM
Enumeration date
03/10/2009
Last updated
03/04/2019
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