Provider Demographics
NPI:1235431388
Name:GOMEZ, ADRIAN Q (DO)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:Q
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3269 STOCKTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:85049-3619
Mailing Address - Country:US
Mailing Address - Phone:928-757-0649
Mailing Address - Fax:928-681-8638
Practice Address - Street 1:3269 STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3619
Practice Address - Country:US
Practice Address - Phone:928-757-0649
Practice Address - Fax:928-681-8638
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2013-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ005917207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine