Healthcare Provider Details

I. General information

NPI: 1821869876
Provider Name (Legal Business Name): HECTOR GUZMAN HERNANDEZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6232 LA SALLE AVE
OAKLAND CA
94611-2846
US

IV. Provider business mailing address

6232 LA SALLE AVE
OAKLAND CA
94611-2846
US

V. Phone/Fax

Practice location:
  • Phone: 510-200-9000
  • Fax: 510-788-4034
Mailing address:
  • Phone: 510-200-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number36823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: