| Jeffrey M Gonzales | |
|
2654 Ne Jill Ct Bend OR 97701-5887 | |
| (541) 419-6337 | |
| (866) 638-8660 |
| Full Name | Jeffrey M Gonzales |
|---|---|
| Speciality | Clinic/center |
| Location | 2654 Ne Jill Ct, Bend, Oregon |
| Authorized Official Name and Position | Jeffrey M Gonzales (OWNER/PROVIDER) |
| Authorized Official Contact | 5414196337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey M Gonzales 2654 Ne Jill Ct Bend OR 97701-5887 Ph: (541) 419-6337 | Jeffrey M Gonzales 2654 Ne Jill Ct Bend OR 97701-5887 Ph: (541) 419-6337 |
| NPI Number | 1285964304 |
|---|---|
| Provider Enumeration Date | 01/12/2010 |
| Last Update Date | 01/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285964304 | NPI | - | NPPES |
| 135382 | Other | OR | OREGON MEDICARE |
| 028408 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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