1437306859 NPI number — J. EDUARDO GUZMAN,MD,. INC.

Table of content: CATHERINE SUZANNE GILL MS, ATC (NPI 1669961041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437306859 NPI number — J. EDUARDO GUZMAN,MD,. INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
J. EDUARDO GUZMAN,MD,. INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437306859
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
420 N MONTEBELLO BLVD
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
MONTEBELLO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90640-4268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-722-1357
Provider Business Mailing Address Fax Number:
323-722-0217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 N MONTEBELLO BLVD
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
MONTEBELLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90640-4268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-722-1357
Provider Business Practice Location Address Fax Number:
323-722-0217
Provider Enumeration Date:
08/27/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CACERES
Authorized Official First Name:
BECKY
Authorized Official Middle Name:
Authorized Official Title or Position:
OFICE MANAGER
Authorized Official Telephone Number:
323-722-1357

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  A38124 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)