Justine A Gonzalez, Od, INC
Optometrist in Long Beach, CA. Organization (NPI-2).
NPI number1124870175
StatusActive
Last updated in NPPESApr 3, 2024
Details
- NPI
- 1124870175
- Entity type
- Organization (NPI-2)
- Legal business name
- Justine A Gonzalez, Od, INC
- Organization subpart
- No
- Enumeration date
- Apr 3, 2024
- Certification date
- Apr 3, 2024
- Last updated
- Apr 3, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
4409 E Los Coyotes DiagonalLong Beach, CA 90815-2820
Phone 562-437-1276
Mailing address
14003 Adoree StLa Mirada, CA 90638-1802
Phone 562-445-5463
Authorized official
Justine Alysse Gonzalez
Optometrist
5624455463
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