Mauricio C Gonzalez
Student in an Organized Health Care Education/Training Program in Pocatello, ID. Individual provider (NPI-1).
NPI number1619708765
StatusActive
Last updated in NPPESAug 12, 2024
Details
- NPI
- 1619708765
- Entity type
- Individual (NPI-1)
- Name
- Mauricio C Gonzalez
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 12, 2024
- Certification date
- Aug 10, 2024
- Last updated
- Aug 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
921 S 8th Ave., Stop 8253Pocatello, ID 83209
Phone 208-282-4726
Mailing address
921 S 8th Ave., Stop 8253Pocatello, ID 83209
Phone 208-282-4726
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All 206 Student in an Organized Health Care Education/Training Program providers in Pocatello · All 2,770 providers in Pocatello
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