Provider Demographics
NPI:1619163649
Name:GONZALEZ, VICTOR JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JOSE
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1115 SE 164TH AVE DEPT 358
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8004
Mailing Address - Country:US
Mailing Address - Phone:360-729-1412
Mailing Address - Fax:360-729-3025
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:DEPT. OF RADIATION ONCOLOGY
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5081
Practice Address - Country:US
Practice Address - Phone:520-694-7236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD612595602085R0001X
UT6359017-12052085R0001X
AZ432822085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology