Healthcare Provider Details

I. General information

NPI: 1548343932
Provider Name (Legal Business Name): TERESITA SALAZAR-GUADIZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17403 WOODRUFF AVE
BELLFLOWER CA
90706-6746
US

IV. Provider business mailing address

17403 WOODRUFF AVE
BELLFLOWER CA
90706-6746
US

V. Phone/Fax

Practice location:
  • Phone: 562-804-0742
  • Fax: 562-804-0744
Mailing address:
  • Phone: 562-804-0742
  • Fax: 562-804-0744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA62175
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: