Provider Demographics
NPI:1194751289
Name:GONZALES, PATRICK D (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:D
Last Name:GONZALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:29798 HAUN RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-6541
Mailing Address - Country:US
Mailing Address - Phone:951-301-3588
Mailing Address - Fax:951-301-4309
Practice Address - Street 1:29798 HAUN RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-6541
Practice Address - Country:US
Practice Address - Phone:951-301-3588
Practice Address - Fax:951-301-4309
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA506690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine