Gonzalez, Octavio

Gonzalez, Octavio is an sole proprietor health care provider with primary practice located at 29409 S Western Ave , Rancho Palos Verdes CA 90275-1137. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Gonzalez, Octavio can be contacted via phone (424) 265-8678.

Contact Information

Primary practice address
29409 S Western Ave Rancho Palos Verdes CA 90275-1137
Phone: (424) 265-8678
Fax: (888) 847-2037
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X A69063 California
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X N3682 Texas

Profile Details

NPI number 1932390069
LBN Legal business name Gonzalez, Octavio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2007
Last updated Feb 7th, 2015 - about 11 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 1932390069 NPPES
Other HD219A PTAN

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