Healthcare Provider Details

I. General information

NPI: 1629983721
Provider Name (Legal Business Name): CARLOS GUZMAN NAUPAY CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 S ANAHEIM BLVD # B11
ANAHEIM CA
92805-6213
US

IV. Provider business mailing address

1440 S ANAHEIM BLVD # B11
ANAHEIM CA
92805-6213
US

V. Phone/Fax

Practice location:
  • Phone: 657-253-0591
  • Fax:
Mailing address:
  • Phone: 657-253-0591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number98865
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: