Corona-Gonzalez, Gonzalo

Corona-Gonzalez, Gonzalo is an individual health care provider with primary practice located at 304 S Lea Ave , Roswell NM 88203-4562. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Corona-Gonzalez, Gonzalo can be contacted via phone (575) 578-4815.

Contact Information

Primary practice address
304 S Lea Ave Roswell NM 88203-4562
Phone: (575) 578-4815
Fax: (575) 578-4814
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 1391 Virgin Islands
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD2007-0650 New Mexico
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD2007-0650 New Mexico

Profile Details

NPI number 1760685234
LBN Legal business name Corona-Gonzalez, Gonzalo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2007
Last updated Nov 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760685234 NPPES
New Mexico MEDICAID 11773537
New Mexico Other VI LICENSE

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