Provider Demographics
NPI:1396988556
Name:GOMEZ, ABEL AGUILERA
Entity type:Individual
Prefix:
First Name:ABEL
Middle Name:AGUILERA
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4515
Mailing Address - Country:US
Mailing Address - Phone:562-981-1501
Mailing Address - Fax:562-981-1502
Practice Address - Street 1:3501 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4515
Practice Address - Country:US
Practice Address - Phone:562-981-1501
Practice Address - Fax:562-981-1502
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)