Provider Demographics
NPI:1699039446
Name:DUENAS GONZALEZ, HECTOR (OD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:
Last Name:DUENAS GONZALEZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 S FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-2549
Mailing Address - Country:US
Mailing Address - Phone:213-749-3888
Mailing Address - Fax:213-747-8670
Practice Address - Street 1:2524 S FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007
Practice Address - Country:US
Practice Address - Phone:213-749-3888
Practice Address - Fax:213-747-8670
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14450152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14450OtherOPTOMETRY LICENSE