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Individual

LESLIE MERCEDES GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
A76307
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A763070
CA
01
204322257
TAX ID
CA
Enumeration date
08/25/2006
Last updated
01/27/2011
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