Provider Demographics
NPI:1366939373
Name:YVETTE M GOZZO MD INC
Entity type:Organization
Organization Name:YVETTE M GOZZO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GOZZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-705-4992
Mailing Address - Street 1:510 SUPERIOR AVE STE 200A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3664
Mailing Address - Country:US
Mailing Address - Phone:949-764-8070
Mailing Address - Fax:949-764-4241
Practice Address - Street 1:510 SUPERIOR AVE STE 200A
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3664
Practice Address - Country:US
Practice Address - Phone:949-764-8070
Practice Address - Fax:949-764-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty