GREG GONZALEZ PEDIATRICS
Ambulatory Health at Loto St, Eagle Point, OR

License number
Oregon MD23838
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: DR. GREG GONZALEZ M.D.
Title: OWNER
Phone: (541) 830-4060
Address
Address
275 Loto St, Eagle Point, OR 97524
National Provider ID: 1588700819
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GREG GONZALEZ PEDIATRICS, PC

10830 Hwy 62, Eagle Point, OR 97524

Registration:
Jun 16, 2004
State ID:
22590590
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Agent:
Greg Gonzalez,130 Vernada Pl, Medford, OR 97504 (Physical)

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