Basic Information
| Provider Information | |||||||||
| NPI: | 1427359637 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANTHONY M. GONZALES MD, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2757 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928590757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149732650 | ||||||||
| FaxNumber: | 7149732655 | ||||||||
| Practice Location | |||||||||
| Address1: | 17772 BEACH BLVD | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926476819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148421473 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2010 | ||||||||
| LastUpdateDate: | 11/04/2010 | ||||||||
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| AuthorizedOfficialLastName: | GONZALES | ||||||||
| AuthorizedOfficialFirstName: | ANTHONY | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7149732650 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A60280 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.