Gomes Enterprises

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHY44817 Issued in CA

Legal business name

GOMES ENTERPRISES

Practice address

3101 Sunset Blvd Ste 2a
Rocklin, CA 95677-3097

Phone

(916) 624-0570

Fax

(916) 624-0591

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Chantell Lee Petralia, OWNER

Title

Owner Ceo

Phone

(888) 852-9373

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• TheMedicineTray Doing business as

Locations

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1962515767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SUNSET BLVD STE 2A",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773097",
            "telephone_number": "916-624-0570",
            "fax_number": "916-624-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SUNSET BLVD STE 2A",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773097",
            "telephone_number": "916-624-0570",
            "fax_number": "916-624-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOMES ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "PETRALIA",
        "authorized_official_first_name": "CHANTELL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "888-852-9373",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY44817",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY44817",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA448170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0519073",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TheMedicineTray",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marissa Gletow
• Chelsea Glissman, DDS
• Krista Glove
• Sean Michael Goetzl
• Gold Country Hearing Associates, Inc
• Ericka Gomez
• Sierra Lynnae Gomez
• Brandis Lynn Gonzales
• Nadja R Gonzales
• Stacy Gonzales, CPE

• Pharmacist in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.