Healthcare Provider Details

I. General information

NPI: 1457278590
Provider Name (Legal Business Name): HILDA JOHANNA GIRON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BYRON FERNANDO GUZMAN

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33174 CAMPUS LN
CATHEDRAL CITY CA
92234-4671
US

IV. Provider business mailing address

33174 CAMPUS LN
CATHEDRAL CITY CA
92234-4671
US

V. Phone/Fax

Practice location:
  • Phone: 442-290-8865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberY16955117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: