MEDICARE: JEWEL DEGUZMAN

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	313M00000X	Nursing Facility/Intermediate Care Facility

Other Identifiers

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

General Provider Information

NPI Number	:	1215364922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEWEL DEGUZMAN

Provider Business Mailing Address
First Line	:	2224 CANARY WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1912
Country	:	US
Telephone Number	:	702-201-8585
Fax Number	:

Provider Business Practice Location Address
First Line	:	2224 CANARY WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1912
Country	:	US
Telephone Number	:	702-201-8585
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEWEL M DEGUZMAN
Credential	:	OA
Telephone Number	:	702-201-8585

Provider Enumeration Date	:	09/27/2013
Last Update Date	:	09/27/2013

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Directions to “JEWEL DEGUZMAN ” Practice Location

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