MEDICARE: DIANA S. GUTH

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	332B00000X	Durable Medical Equipment & Medical Supplies	103600	CA

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	:	1598760266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANA S. GUTH

Provider Business Mailing Address
First Line	:	2370 WESTWOOD BLVD
Second Line	:	STE D
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2120
Country	:	US
Telephone Number	:	310-441-4640
Fax Number	:	310-441-4642

Provider Business Practice Location Address
First Line	:	2370 WESTWOOD BLVD
Second Line	:	STE D
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2120
Country	:	US
Telephone Number	:	310-441-4640
Fax Number	:	310-441-4642

Authorized Official
Title or Position	:	OWNER
Name	:	DIANA S. GUTH
Credential	:	RRT
Telephone Number	:	310-441-4640

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	02/15/2012

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