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NPI Code Detail

MEDICARE: CATHRYN DE GUZMAN PA-C

MEDICARE: CATHRYN DE GUZMAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant56870CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033778576
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHRYN DE GUZMAN PA-C
Provider Business Mailing Address
First Line : 91275 66TH AVE
Second Line : SUITE 500
City : MECCA
State : CA
Zip : 92254
Country : US
Telephone Number : 760-396-1249
Fax Number : 760-396-1253
Provider Business Practice Location Address
First Line : 91275 66TH ST SUITE 500
Second Line :
City : MECCA
State : CA
Zip : 92254-1251
Country : US
Telephone Number : 760-396-1249
Fax Number : 760-396-1253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2019
Last Update Date : 07/14/2022

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Directions to “ CATHRYN DE GUZMAN PA-C” Practice Location

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