Provider Demographics
NPI:1740511260
Name:GONZALEZ, FRANK V
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:GONZALEZ
Suffix:V
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 1:301 W VINEYARD AVE APT 465
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2078
Mailing Address - Country:US
Mailing Address - Phone:760-509-6003
Mailing Address - Fax:
Practice Address - Street 1:NMCB 4
Practice Address - Street 2:25284
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96601-4941
Practice Address - Country:US
Practice Address - Phone:760-509-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman