Provider Demographics
NPI:1659418341
Name:GOMEZ, GILBERTO (DC)
Entity Type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 W 3RD ST
Mailing Address - Street 2:200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1930
Mailing Address - Country:US
Mailing Address - Phone:213-387-8935
Mailing Address - Fax:213-387-1808
Practice Address - Street 1:2350 W 3RD ST
Practice Address - Street 2:200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1930
Practice Address - Country:US
Practice Address - Phone:213-387-8935
Practice Address - Fax:213-387-1808
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor