Healthcare Provider Details

I. General information

NPI: 1841381217
Provider Name (Legal Business Name): PHYLLIS A. GUZE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILLSHIRE BLVD BLDG 500; RM 3210
LOS ANGELES CA
90073
US

IV. Provider business mailing address

679 THAYER AVE
LOS ANGELES CA
90024
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3125
  • Fax: 310-268-4818
Mailing address:
  • Phone: 310-268-3125
  • Fax: 310-268-4818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberG 23384
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: