Provider Demographics
NPI:1326058348
Name:GOPEZ, MARIA REMEDIOS R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:REMEDIOS R
Last Name:GOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:81767 DOCTOR CARREON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5597
Mailing Address - Country:US
Mailing Address - Phone:760-347-1615
Mailing Address - Fax:760-347-1635
Practice Address - Street 1:81767 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5509
Practice Address - Country:US
Practice Address - Phone:760-347-1615
Practice Address - Fax:760-347-1635
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA73104208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A731040Medicaid