Healthcare Provider Details

I. General information

NPI: 1780820530
Provider Name (Legal Business Name): GUILLERMO ALBERTO GUZMAN ARROYO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W. 6TH STREET
LOS ANGELES CA
90017
US

IV. Provider business mailing address

1422 N. KINGSLEY DR #209
LOS ANGELES CA
90027
US

V. Phone/Fax

Practice location:
  • Phone: 213-413-5151
  • Fax:
Mailing address:
  • Phone: 310-701-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number62884
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: