NPIMap

Organization Active NPI

Gonzalo Corzo, D.D.S. a Professional Corporation

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1548567480
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52366 Issued in CA
Legal business name
GONZALO CORZO, D.D.S. A PROFESSIONAL CORPORATION
Practice address
875 N Western Ave
Los Angeles, CA 90029-3759
Phone
(323) 798-5427
Fax
(323) 798-5442
NPI assigned
Feb 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Gonzalo Corzo, D.D.S.
Title
President/Ceo
Phone
(323) 798-5427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 52366 CA Primary

Addresses

Primary practice location

875 N Western Ave
Los Angeles, CA 90029-3759

Mailing address

875 N Western Ave
Los Angeles, CA 90029-3759
Phone (323) 798-5427

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1548567480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-798-5427",
            "fax_number": "323-798-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-798-5427",
            "fax_number": "323-798-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONZALO CORZO, D.D.S. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "CORZO",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "323-798-5427",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.