Gonzalez, Octavio
Gonzalez, Octavio is an sole proprietor health care provider with primary practice located at 29409 S Western Ave , Rancho Palos Verdes CA 90275-1137. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Gonzalez, Octavio can be contacted via phone (424) 265-8678.Contact Information
Primary practice address
29409 S Western Ave
Rancho Palos Verdes CA 90275-1137
Phone: (424) 265-8678
Fax: (888) 847-2037
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | A69063 | California |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | N3682 | Texas |
Profile Details
| NPI number | 1932390069 |
|---|---|
| LBN Legal business name | Gonzalez, Octavio |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 5th, 2007 |
| Last updated | Feb 7th, 2015 - about 9 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 | 1932390069 | NPPES |
| Other | HD219A | PTAN |
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