Healthcare Provider Details
I. General information
NPI: 1811736275
Provider Name (Legal Business Name): THE GUARDIAN GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2024
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14623 HAWTHORNE BLVD STE 400
LAWNDALE CA
90260-1581
US
IV. Provider business mailing address
95 3RD ST FL 2
SAN FRANCISCO CA
94103-3103
US
V. Phone/Fax
- Phone: 800-411-1006
- Fax: 310-356-7910
- Phone: 888-240-2019
- Fax: 310-356-7910
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 202C00000X |
| Taxonomy | Independent Medical Examiner Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
SWEENEY
Title or Position: DIRECTOR
Credential:
Phone: 888-240-2019