Gonzalez-Vitale, Juan Carlos

Gonzalez-Vitale, Juan Carlos is an individual health care provider with primary practice located at 2801 N Gantenbein Ave , Portland OR 97227-1623. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Gonzalez-Vitale, Juan Carlos can be contacted via phone (503) 413-4813.

Contact Information

Primary practice address
2801 N Gantenbein Ave Portland OR 97227-1623
Phone: (503) 413-4813
Fax: (503) 413-2982
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X MD16262 Oregon

Profile Details

NPI number 1942348263
LBN Legal business name Gonzalez-Vitale, Juan Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated May 7th, 2009 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942348263 NPPES
Oregon MEDICAID 036629
Oregon MEDICAID 0134819
Oregon Other 036629

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