Provider Demographics
NPI:1376880724
Name:GOCHICOA, ENRIQUE PABLO (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:PABLO
Last Name:GOCHICOA
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 SALEM LN NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1919
Mailing Address - Country:US
Mailing Address - Phone:202-338-0028
Mailing Address - Fax:
Practice Address - Street 1:6935 LAUREL AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4413
Practice Address - Country:US
Practice Address - Phone:202-731-7203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02026171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist