Provider Demographics
NPI:1144382227
Name:GOMEZ, ALDO (PA-C)
Entity type:Individual
Prefix:
First Name:ALDO
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LIVE OAK WAY
Mailing Address - Street 2:402
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-7249
Mailing Address - Country:US
Mailing Address - Phone:650-468-7516
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:BLD 80
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17411363A00000X
CACA17411261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health