Active NPI
David Gonzales
- Anesthesiology Physician
- Crescent City, CA
National Provider Identifier
1477063709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G64302
- Practice address
- 270 Chevy Chase Way
Crescent City, CA 95531-8373 - Phone
- (707) 464-1520
- NPI assigned
- Sep 29, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G64302 | CA | Primary |
| General Practice Physician | 208D00000X | G64302 | CA |
Addresses
Primary practice location
270 Chevy Chase Way
Crescent City, CA 95531-8373
Mailing address
PO Box 270
Crescent City, CA 95531-0270
Phone (707) 464-1520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G64302 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506643200000",
"number": "1477063709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 270",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955310270",
"telephone_number": "707-464-1520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 CHEVY CHASE WAY",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955318373",
"telephone_number": "707-464-1520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-29",
"last_updated": "2017-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G64302",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "G64302",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.