Individual
EZEQUIEL GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1020 S ARROYO PKWY, PASADENA, CA 91105-3911
(626) 403-2794
Mailing address
12977 OSBORNE ST, PACOIMA, CA 91331-3338
(818) 439-8532
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
251269
CA
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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