Provider Demographics
NPI:1104799576
Name:GONZALEZ, EDUARDO A (DC)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:A
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 BLACKBERRY CT
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-1843
Mailing Address - Country:US
Mailing Address - Phone:760-877-7084
Mailing Address - Fax:
Practice Address - Street 1:670 GREGORY LN STE C
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2771
Practice Address - Country:US
Practice Address - Phone:925-395-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC37391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty