Healthcare Provider Details

I. General information

NPI: 1487073375
Provider Name (Legal Business Name): DIANA S GUTH RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DBA HOME RESPIRATORY CARE

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 WESTWOOD BLVD SUITE D
LOS ANGELES CA
90064-2181
US

IV. Provider business mailing address

2370 WESTWOOD BLVD SUITE D
LOS ANGELES CA
90064-2181
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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number103600
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: