Individual
MIQUEL DEAN GOMEZ II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10150 N 67TH AVE STE 101, GLENDALE, AZ 85302-1004
(623) 561-4547
(623) 412-4995
Mailing address
10150 N 67TH AVE STE 101, GLENDALE, AZ 85302-1004
(623) 561-4547
(623) 412-4995
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
23411
AZ
207RP1001X
Pulmonary Disease Physician
AZ23411
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324244
—
AZ
Enumeration date
06/26/2006
Last updated
06/20/2011
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