Provider Demographics
NPI:1790969970
Name:GONZALES, BRIAN PIZARRO (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PIZARRO
Last Name:GONZALES
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 1:2200 HAMNER AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-2673
Mailing Address - Country:US
Mailing Address - Phone:909-472-8529
Mailing Address - Fax:
Practice Address - Street 1:555 QUEENSLAND CIR STE 102
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1380
Practice Address - Country:US
Practice Address - Phone:951-805-3077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30531111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor