Healthcare Provider Details

I. General information

NPI: 1902418205
Provider Name (Legal Business Name): JOHN PAUL GUZMAN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4341 PIEDMONT AVE STE 201
OAKLAND CA
94611-4792
US

IV. Provider business mailing address

1808 OAK PARK BLVD APT 33
PLEASANT HILL CA
94523-4485
US

V. Phone/Fax

Practice location:
  • Phone: 510-547-1630
  • Fax:
Mailing address:
  • Phone: 916-862-2295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number298717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: