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18 Fourth Street Gonzales CA 93926-0808 | |
| (831) 975-3124 | |
| (831) 305-6400 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 18 Fourth Street, Gonzales, California |
| Authorized Official Name and Position | Ignacio Guzman (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5598924500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 676 Gonzales CA 93926-0676 Ph: (831) 975-3124 | 18 Fourth Street Gonzales CA 93926-0808 Ph: (831) 975-3124 |
| NPI Number | 1184176158 |
|---|---|
| Provider Enumeration Date | 10/26/2016 |
| Last Update Date | 10/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184176158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 545778 (California) | Primary |
Gonzales Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 Fourth Street, Gonzales, CA 93926 Phone: 831-675-3601 Fax: 831-675-3966 | |
Ocean Breeze Home Health Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Alta Street, Gonzales, CA 93926 Phone: 800-207-0611 Fax: 800-214-3114 |