Healthcare Provider Details

I. General information

NPI: 1053748681
Provider Name (Legal Business Name): CARLOS SANTANA GUZMAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 KING AVE
CORCORAN CA
93212-9611
US

IV. Provider business mailing address

6324 W DOE AVE APT 203
VISALIA CA
93291-8278
US

V. Phone/Fax

Practice location:
  • Phone: 787-934-4327
  • Fax:
Mailing address:
  • Phone: 787-934-4327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number19165
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC207723
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: