Octavio Gonzalez MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

A69063 Issued in CA

Legal business name

OCTAVIO GONZALEZ MD

Practice address

29409 S Western Ave
Rancho Palos Verdes, CA 90275-1137

Phone

(424) 265-8678

Fax

(888) 847-2037

NPI assigned

Mar 14, 2013

Last updated

Mar 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Octavio Gonzalez, MDNPI 1932390069

Title

President

Phone

(424) 265-8678

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Octavio Gonzalez, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Rancho Palos Verdes, CA
  • NPI 1932390069
  Authorized official Same address or phone

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426204800000",
    "number": "1912248030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3062",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103062",
            "telephone_number": "424-265-8678",
            "fax_number": "888-847-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29409 S WESTERN AVE",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751137",
            "telephone_number": "424-265-8678",
            "fax_number": "888-847-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCTAVIO GONZALEZ MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2015-03-13",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "424-265-8678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A69063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nu-Era Home Health Agency, Inc
• Maria Nucum, OTR
• Ocean Front Urgent Care P.C
• Oceanaire Residential Treatment Program
• Oceanview Estates Inc
• Rachel Ohara, DPT
• Eriko Okubo
• Otra Lee Olver, D.C.
• Katelyn Oropeza
• Glenda S Owens, R.PH

• Sports Medicine (Orthopaedic Surgery) Physician in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.