Healthcare Provider Details

I. General information

NPI: 1326815341
Provider Name (Legal Business Name): ANNIE GUAN MSN, APRN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S FAIR OAKS AVE STE 305
PASADENA CA
91105-2562
US

IV. Provider business mailing address

301 S FAIR OAKS AVE STE 305
PASADENA CA
91105-2562
US

V. Phone/Fax

Practice location:
  • Phone: 626-440-7325
  • Fax:
Mailing address:
  • Phone: 626-440-7325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95026618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: