Healthcare Provider Details

I. General information

NPI: 1699444273
Provider Name (Legal Business Name): ASHLEY LAUREN SERVIDAD GUANZON PHARMD, BCIDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

6500 WILSHIRE BLVD STE 2300
LOS ANGELES CA
90048-4943
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-3277
  • Fax:
Mailing address:
  • Phone: 310-423-3277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number85101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: