Healthcare Provider Details

I. General information

NPI: 1750048054
Provider Name (Legal Business Name): ALEXANDER GUZMAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2021
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7547 E SOUTHERN AVE
MESA AZ
85209-2741
US

IV. Provider business mailing address

7547 E SOUTHERN AVE
MESA AZ
85209-2741
US

V. Phone/Fax

Practice location:
  • Phone: 480-830-9249
  • Fax:
Mailing address:
  • Phone: 480-830-9249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS025583
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: