Individual
ROBERT ANTONIO GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(714) 616-0639
Mailing address
PO BOX 28374, ANAHEIM, CA 92809-0145
(714) 616-0639
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
CA
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
CA
Other
Enumeration date
08/08/2018
Last updated
08/10/2018
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