Provider Demographics
NPI:1285652651
Name:GONZALEZ, ADALBERTO CASTRO (MD)
Entity Type:Individual
Prefix:
First Name:ADALBERTO
Middle Name:CASTRO
Last Name:GONZALEZ
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 1:3219 E CAMELBACK RD
Mailing Address - Street 2:SUITE 833
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2307
Mailing Address - Country:US
Mailing Address - Phone:602-266-5100
Mailing Address - Fax:602-266-7100
Practice Address - Street 1:5333 N 7TH ST
Practice Address - Street 2:SUITE B219
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2821
Practice Address - Country:US
Practice Address - Phone:602-266-5100
Practice Address - Fax:602-266-7100
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12521208G00000X
TXL9706208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ29874Medicare PIN
AZD36929Medicare UPIN