Gonzalez, Nicolas Antonio

Gonzalez, Nicolas Antonio is an sole proprietor health care provider with primary practice located at 2600 E Southern Ave Bldg. H, Tempe AZ 85282. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gonzalez, Nicolas Antonio can be contacted via phone (480) 699-7248.

Contact Information

Primary practice address
2600 E Southern Ave Bldg. H Tempe AZ 85282
Phone: (480) 699-7248
Fax: (480) 664-1961
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 29730 Arizona

Profile Details

NPI number 1013916659
LBN Legal business name Gonzalez, Nicolas Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2005
Last updated Jun 8th, 2011 - about 15 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 1013916659 NPPES
Arizona Other 3Z0260 HEALTHNET
Arizona MEDICAID 610560 HEALTHNET

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