Provider Demographics
NPI:1154432847
Name:GONZALES, ARLENE C (MD)
Entity type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:C
Last Name:GONZALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:722 E CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4524
Mailing Address - Country:US
Mailing Address - Phone:805-928-9600
Mailing Address - Fax:805-928-9622
Practice Address - Street 1:722 E CHAPEL ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4524
Practice Address - Country:US
Practice Address - Phone:805-928-9600
Practice Address - Fax:805-928-9622
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG67298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G67298Medicare ID - Type Unspecified
E59279Medicare UPIN