Provider Demographics
NPI:1194474627
Name:PAZ-SOLDAN, GONZALO JAVIER (MD)
Entity type:Individual
Prefix:
First Name:GONZALO
Middle Name:JAVIER
Last Name:PAZ-SOLDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ASHLAND PL APT 16L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4079
Mailing Address - Country:US
Mailing Address - Phone:202-997-9483
Mailing Address - Fax:
Practice Address - Street 1:1200 N STATE ST RM 1011
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-1001
Practice Address - Country:US
Practice Address - Phone:202-997-9483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program