Provider Demographics
NPI:1326431016
Name:GONZALES, ANGELA LOIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LOIS
Last Name:GONZALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2576 HAMNER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-1922
Mailing Address - Country:US
Mailing Address - Phone:951-582-0262
Mailing Address - Fax:877-700-5045
Practice Address - Street 1:2576 HAMNER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-1922
Practice Address - Country:US
Practice Address - Phone:951-582-0262
Practice Address - Fax:877-700-5045
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG070532208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics