Provider Information for 1659740843
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IVETTE GONZALEZ M.S.
Sex: Female
NPI: 1659740843
Last Updated: 2023-01-06
Certification Date: 2023-01-06
Certification Date: 2023-01-06
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1659740843 | ||||||||||||
| Enumeration Date | 2015-09-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 919 FULLERTON, CA 92836-0919 United States Phone: 714-680-9000 | Fax:714-680-3839 | ||||||||||||
| Primary Practice Address | 801 E CHAPMAN AVE STE 203 FULLERTON, CA 92831-3846 United States Phone: 714-680-9000 | Fax:714-680-3839 | ||||||||||||
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