Healthcare Provider Details

I. General information

NPI: 1740208586
Provider Name (Legal Business Name): DAVID LEE GUZMAN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3379 BEARD RD
NAPA CA
94558-3407
US

IV. Provider business mailing address

3379 BEARD RD
NAPA CA
94558-3407
US

V. Phone/Fax

Practice location:
  • Phone: 707-224-4800
  • Fax: 707-224-3644
Mailing address:
  • Phone: 707-224-4800
  • Fax: 707-224-3644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000E38250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: