Healthcare Provider Details

I. General information

NPI: 1841123023
Provider Name (Legal Business Name): DOCTER-GUZMAN MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9608 VAN NUYS BLVD STE 104
PANORAMA CITY CA
91402-1042
US

IV. Provider business mailing address

9608 VAN NUYS BLVD STE 104
PANORAMA CITY CA
91402-1042
US

V. Phone/Fax

Practice location:
  • Phone: 650-793-5084
  • Fax:
Mailing address:
  • Phone: 650-793-5084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR DOCTER
Title or Position: OWNER
Credential:
Phone: 650-793-5084