Provider Demographics
NPI:1639619398
Name:BARRAZA, GONZALO ELIAZ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GONZALO
Middle Name:ELIAZ
Last Name:BARRAZA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 S ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-3953
Mailing Address - Country:US
Mailing Address - Phone:805-483-5635
Mailing Address - Fax:
Practice Address - Street 1:2851 S ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3953
Practice Address - Country:US
Practice Address - Phone:805-483-5635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73740183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist