MEDICARE: DR. JOHN V DEGUZMAN MD

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	174400000X	Specialist	22208	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22208	OTHER	AZ	STATE LICENSE

General Provider Information

NPI Number	:	1558347153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN V DEGUZMAN MD

Provider Business Mailing Address
First Line	:	4400 N 32ND ST
Second Line	:	SUITE 140
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3953
Country	:	US
Telephone Number	:	602-258-4018
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 N 32ND ST
Second Line	:	SUITE 140
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3953
Country	:	US
Telephone Number	:	602-258-4018
Fax Number	:

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	01/29/2008

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Directions to “ DR. JOHN V DEGUZMAN MD” Practice Location

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