| Kasein Gonzalez, Md, Inc | |
|
303 W Katella Ave Ste 308 Orange CA 92867-4790 | |
| (714) 602-6660 | |
| (714) 602-6550 |
| Full Name | Kasein Gonzalez, Md, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 303 W Katella Ave Ste 308, Orange, California |
| Authorized Official Name and Position | Kasein G Gonzalez (OWNER) |
| Authorized Official Contact | 7146026660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kasein Gonzalez, Md, Inc Po Box 2491 Orange CA 92859-0491 Ph: (714) 602-6660 | Kasein Gonzalez, Md, Inc 303 W Katella Ave Ste 308 Orange CA 92867-4790 Ph: (714) 602-6660 |
| NPI Number | 1942787999 |
|---|---|
| Provider Enumeration Date | 07/23/2018 |
| Last Update Date | 04/17/2020 |
| Medicare PECOS PAC ID | 7719223429 |
|---|---|
| Medicare Enrollment ID | O20190116001741 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942787999 | NPI | - | NPPES |
| 1942787999 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A117390 (* (Not Available)) | Primary |
| Provider Name | Kasein Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700049459 PECOS PAC ID: 9638326762 Enrollment ID: I20120824000595 |
| Provider Name | Frederica D Yarborough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528552353 PECOS PAC ID: 0042646556 Enrollment ID: I20200420002761 |
| Provider Name | Jane Nava |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528731353 PECOS PAC ID: 0547659625 Enrollment ID: I20211110002527 |
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