Provider Demographics
NPI:1487710463
Name:GONZALEZ VELEZ, JUAN MIGUEL (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:MIGUEL
Last Name:GONZALEZ VELEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 KING ST
Mailing Address - Street 2:UNIT 535
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-1627
Mailing Address - Country:US
Mailing Address - Phone:267-207-1923
Mailing Address - Fax:
Practice Address - Street 1:550 16TH ST FL 7
Practice Address - Street 2:BOX 0132
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2549
Practice Address - Country:US
Practice Address - Phone:415-514-9399
Practice Address - Fax:415-476-1811
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT180622207VM0101X
MI4301095334207VM0101X
CAA 121943207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine