Organization
MIGUEL GONZALEZ MD PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL GONZALEZ M.D. (PRESIDENT)
(805) 497-7508
Entity
Organization
Contact information
Practice address
227 W JANSS RD, SUITE 250, THOUSAND OAKS, CA 91360-1848
(805) 497-7508
(805) 495-6834
Mailing address
227 W JANSS RD, SUITE 250, THOUSAND OAKS, CA 91360-1848
(805) 497-7508
(805) 495-6834
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G51766
MEDICAL LICENSE
CA
Enumeration date
05/11/2007
Last updated
09/01/2010
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