Gonzales, Darrell Wayne
Gonzales, Darrell Wayne is an sole proprietor health care provider with primary practice located at 9850 Genesee Ave Suite 500, La Jolla CA 92037-1224. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Gonzales, Darrell Wayne can be contacted via phone (858) 657-0267.Contact Information
Primary practice address
9850 Genesee Ave Suite 500
La Jolla CA 92037-1224
Phone: (858) 657-0267
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | A88738 | California |
Profile Details
| NPI number | 1417960188 |
|---|---|
| LBN Legal business name | Gonzales, Darrell Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 14th, 2006 |
| Last updated | May 13th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417960188 | NPPES |
| California | Other | A88738 | MEDICAL LICENSE |
| California | Other | 1346488004 | MEDICAL LICENSE |
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