Healthcare Provider Details

I. General information

NPI: 1598760266
Provider Name (Legal Business Name): DIANA S. GUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 WESTWOOD BLVD STE D
LOS ANGELES CA
90064-2120
US

IV. Provider business mailing address

2370 WESTWOOD BLVD STE D
LOS ANGELES CA
90064-2120
US

V. Phone/Fax

Practice location:
  • Phone: 310-441-4640
  • Fax: 310-441-4642
Mailing address:
  • Phone: 310-441-4640
  • Fax: 310-441-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number103600
License Number StateCA

VIII. Authorized Official

Name: DIANA S. GUTH
Title or Position: OWNER
Credential: RRT
Phone: 310-441-4640