| Jose Manuel Gonzalez-diaz | |
|
20440 Sherman Way Canoga Park CA 91306-3110 | |
| (818) 994-6177 | |
| (818) 994-6177 |
| Full Name | Jose Manuel Gonzalez-diaz |
|---|---|
| Speciality | Family Medicine |
| Location | 20440 Sherman Way, Canoga Park, California |
| Authorized Official Name and Position | Jose Manuel Gonzalez-diaz (OWNER) |
| Authorized Official Contact | 8189946177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jose Manuel Gonzalez-diaz 20440 Sherman Way Canoga Park CA 91306-3110 Ph: (818) 994-6177 | Jose Manuel Gonzalez-diaz 20440 Sherman Way Canoga Park CA 91306-3110 Ph: (818) 994-6177 |
| NPI Number | 1467517557 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 10/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467517557 | NPI | - | NPPES |
| GR0086102 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A41311 (California) | Primary |
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