Lionel Madrid Gonzales Jr., PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10115 Issued in CA

Practice address

1310 W Stewart Dr
Suite 503
Orange, CA 92868-3854

Phone

(714) 997-2224

Fax

(714) 997-1187

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326072950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W. STEWART DRIVE",
            "address_2": "SUITE 503",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683856",
            "telephone_number": "714-997-2224",
            "fax_number": "714-997-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR",
            "address_2": "SUITE 503",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683854",
            "telephone_number": "714-997-2224",
            "fax_number": "714-997-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "LIONEL",
        "middle_name": "MADRID",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA10115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA10115",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Gonzales
• Alondra Gonzales
• Amber Y. Gonzales
• Anne Gonzales, MSN-FNP
• Giselle Gonzales
• Mailah Starr Gonzales
• Reve Christine Gonzales
• Sara Magdalena Gonzales
• Sebastian Andrew Gonzales III, D.C.
• Tiffany Marie Gonzales

• Surgical Physician Assistant in Orange, CA
• Providers in Orange, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.