Healthcare Provider Details

I. General information

NPI: 1346324720
Provider Name (Legal Business Name): LINO J DEGUZMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 SAND CANYON AVE
IRVINE CA
92618-3716
US

IV. Provider business mailing address

16100 SAND CANYON AVE
IRVINE CA
92618-3716
US

V. Phone/Fax

Practice location:
  • Phone: 949-727-1232
  • Fax: 949-727-9615
Mailing address:
  • Phone: 949-727-1232
  • Fax: 949-727-9615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA46594
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: