Healthcare Provider Details

I. General information

NPI: 1770895724
Provider Name (Legal Business Name): IGNACIO GUZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1354 W HERNDON AVE
FRESNO CA
93711-0431
US

IV. Provider business mailing address

1354 W HERNDON AVE
FRESNO CA
93711-0431
US

V. Phone/Fax

Practice location:
  • Phone: 559-298-9600
  • Fax: 559-298-9605
Mailing address:
  • Phone: 559-298-9600
  • Fax: 559-298-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA113019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: