Provider Demographics
NPI:1760611677
Name:GOMEZ, GERHARD FRANCOIS (MD)
Entity Type:Individual
Prefix:DR
First Name:GERHARD
Middle Name:FRANCOIS
Last Name:GOMEZ
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:PO BOX 10261
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-0261
Mailing Address - Country:US
Mailing Address - Phone:602-824-8404
Mailing Address - Fax:602-899-6550
Practice Address - Street 1:2122 E HIGHLAND AVE STE 335
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4760
Practice Address - Country:US
Practice Address - Phone:602-824-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ497912084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5315067497Medicaid