Provider Demographics
NPI:1679797369
Name:GONZALEZ-COTA, ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:GONZALEZ-COTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W GUDE DR STE 375
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4300
Mailing Address - Country:US
Mailing Address - Phone:301-962-4278
Mailing Address - Fax:833-781-1112
Practice Address - Street 1:30 W GUDE DR STE 375
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4300
Practice Address - Country:US
Practice Address - Phone:301-962-4278
Practice Address - Fax:833-781-1112
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0009637207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE223334YCLPMedicare PIN