| Jaime Gonzalez, M.d., Inc. | |
|
350 Vinton Ave Suite 204 Pomona CA 91767-3000 | |
| (909) 622-3353 | |
| (909) 622-3833 |
| Full Name | Jaime Gonzalez, M.d., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 350 Vinton Ave, Pomona, California |
| Authorized Official Name and Position | Jaime Gonzalez (PRESIDENT) |
| Authorized Official Contact | 9096223353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaime Gonzalez, M.d., Inc. 350 Vinton Ave Suite 204 Pomona CA 91767-3000 Ph: (909) 622-3353 | Jaime Gonzalez, M.d., Inc. 350 Vinton Ave Suite 204 Pomona CA 91767-3000 Ph: (909) 622-3353 |
| NPI Number | 1588730162 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 10/08/2008 |
| Medicare PECOS PAC ID | 3072615715 |
|---|---|
| Medicare Enrollment ID | O20070226000791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588730162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A87328 (California) | Primary |
| Provider Name | Jaime Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235180563 PECOS PAC ID: 5193795789 Enrollment ID: I20040729001626 |
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