Provider Demographics
NPI:1821670068
Name:GONZAGA, MARIA ISABEL (MD)
Entity type:Individual
Prefix:
First Name:MARIA ISABEL
Middle Name:
Last Name:GONZAGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N STATE STREET
Mailing Address - Street 2:CT-A-7-D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:323-409-6931
Mailing Address - Fax:323-441-8185
Practice Address - Street 1:1100 N STATE STREET
Practice Address - Street 2:CT-A-7-D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-409-6931
Practice Address - Fax:323-441-8185
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10075331207V00000X
CAA202791207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology