OrganizationRodolfo Gonzalez(<Unavail>)DentistDental ProvidersPractice Address8800 Ave Via De La Juventud, Tijuana, Baja California 22010 (Mexico)(619) 488-3200PECOS EnrollmentBased on the most recent information from CMS, provider Rodolfo Gonzalez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1770086621Provider TypeOrganizationFull NameRodolfo GonzalezOther Name<Unavail>SubpartNoEnumeration Date3/16/2018Last Updated3/16/2018Contact InformationPractice LocationPractice Address8800 Ave Via De La Juventud, Tijuana, Baja California 22010 (Mexico)Phone(619) 488-3200Fax(866) 272-6924Mailing LocationMailing Address8800 Ave Via De La Juventud, Tijuana, Baja California 22010 (Mexico)PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameGonzalez, Rodolfo (Dentist)Phone(619) 488-3200Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer