Individual
JAIME E GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12401 WASHINGTON BLVD, WHITTIER, CA 90602-1006
(562) 698-0811
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(800) 506-6895
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A70475
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A704750
BLUE SHIELD
CA
05
—
00A704750
—
CA
01
—
P00018956
RAILROAD MEDICARE
CA
Enumeration date
06/27/2006
Last updated
07/08/2007
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