Provider Demographics
NPI:1285489369
Name:GOMEZ, FRENCH MARI QUIZON (RPH)
Entity type:Individual
Prefix:MR
First Name:FRENCH MARI
Middle Name:QUIZON
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 GOOSE CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2470
Mailing Address - Country:US
Mailing Address - Phone:336-817-7086
Mailing Address - Fax:
Practice Address - Street 1:3416 DEER VALLEY RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-6650
Practice Address - Country:US
Practice Address - Phone:925-978-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist