Provider Demographics
NPI:1801602503
Name:GONZALEZ, VICTOR ANDRES (PA)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:ANDRES
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:1955 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6282
Practice Address - Country:US
Practice Address - Phone:480-728-3000
Practice Address - Fax:480-728-4747
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2025-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ11334363AS0400X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant