| Doctor Name: | ENRIQUE JOSE GONZALEZ |
| NPI Number: | 1023161684 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | G74790 |
| Business Practice Address: | 4755 Cesar Chavez Ave #a Los Angeles, CA - 900221200 |
| Business Phone Number: | 3232624194 |
| Business Fax Number: | 3232614124 |
| Mailing Address: | 4755 Cesar Chavez Ave #a, LOS ANGELES |
| State: | CA |
| Postal Code: | 900221200 |
| Phone Number: | 3232624194 |
| Fax Number: | 3232614124 |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 12/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G74790 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |