Basic Information
| Provider Information | |||||||||
| NPI: | 1003827692 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GONZALEZ | ||||||||
| FirstName: | ARMANDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 43160 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857333160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207223777 | ||||||||
| FaxNumber: | 5202966224 | ||||||||
| Practice Location | |||||||||
| Address1: | 395 N SILVERBELL RD | ||||||||
| Address2: | #265 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857452675 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206242194 | ||||||||
| FaxNumber: | 5206242193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 02/14/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 24499 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1Z7691 | 01 | HEALTH NET | OTHER | 357196 | 01 | AHCCCS MEDICAID | OTHER | 0410782 | 01 | EVERCARE | OTHER | 357196003 | 01 | AHCCCS MERCY CARE | OTHER | AZ0893150 | 01 | BCBS OF ARIZONA | OTHER | 002000386 | 01 | CIGNA | OTHER | 5802220 | 01 | AETNA OLD #621902 | OTHER | 205906600 | 01 | DEPT OF LABOR | OTHER | P00080368 | 01 | RAILROAD MEDICARE | OTHER |