Healthcare Provider Details

I. General information

NPI: 1225168446
Provider Name (Legal Business Name): KAREN E GUINN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 E GREEN ST
PASADENA CA
91106-2505
US

IV. Provider business mailing address

1175 E GREEN ST
PASADENA CA
91106-2505
US

V. Phone/Fax

Practice location:
  • Phone: 626-578-1687
  • Fax: 626-578-1594
Mailing address:
  • Phone: 626-578-1687
  • Fax: 626-578-1594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number31275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: