Healthcare Provider Details

I. General information

NPI: 1043662307
Provider Name (Legal Business Name): JAMES R GUZMAN B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JIMMY GUZMAN

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 S CHESTNUT AVE
FRESNO CA
93702-4709
US

IV. Provider business mailing address

135 SAN JOSE AVE
CLOVIS CA
93612-2624
US

V. Phone/Fax

Practice location:
  • Phone: 559-453-2274
  • Fax:
Mailing address:
  • Phone: 559-623-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: