Eduardo Juan Gonzaga Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35-053203 Issued in OH

Practice address

111H C/O the Jerry L Pettis Vamc
11201 Benton Street
Loma Linda, CA 92357-0001

Phone

(909) 583-6176

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922188200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111H C/O THE JERRY L PETTIS VAMC",
            "address_2": "11201 BENTON STREET",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923570001",
            "telephone_number": "909-583-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111H C/O THE JERRY L PETTIS VAMC",
            "address_2": "11201 BENTON STREET",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923570001",
            "telephone_number": "909-583-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZAGA",
        "first_name": "EDUARDO",
        "middle_name": "JUAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-053203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jannette Gomez
• Jesus Eduardo Gomez, M.D.
• Nephtali Ruiz Gomez, M.D.
• Roseann Merie Gomez
• Gillian Gomulka, RN
• Carmen Protesta Gonzales-Nate, M.D.
• Mary Christine Deasis Gonzales, MSN,FNP-C
• Athenna Gonzalez
• Danessa Gonzalez
• Jody Michelle Gonzalez, PHARMD

• Internal Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Internal Medicine Physician 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.