Healthcare Provider Details

I. General information

NPI: 1235228594
Provider Name (Legal Business Name): EUGENE GUZMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

947 BLANCO CIR STE A
SALINAS CA
93901-4461
US

IV. Provider business mailing address

4 ROSSI CIR STE 101
SALINAS CA
93907-2358
US

V. Phone/Fax

Practice location:
  • Phone: 831-422-5555
  • Fax: 831-422-5199
Mailing address:
  • Phone: 831-757-4444
  • Fax: 831-757-4419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA10200
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: