MEDICARE: CUILING GUAN

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
1	225700000X	Massage Therapist	23-F7493416	CA

General Provider Information

NPI Number	:	1134907041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CUILING GUAN

Provider Business Mailing Address
First Line	:	4539 GOLDEN ALDER ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-2476
Country	:	US
Telephone Number	:	415-568-1351
Fax Number	:

Provider Business Practice Location Address
First Line	:	4539 GOLDEN ALDER ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-2476
Country	:	US
Telephone Number	:	415-568-1351
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	09/20/2023

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Directions to “ CUILING GUAN ” Practice Location

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