Healthcare Provider Details

I. General information

NPI: 1336059864
Provider Name (Legal Business Name): JORGE LUIS PANDO GUZMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1322 N AVALON BLVD
WILMINGTON CA
90744-2639
US

IV. Provider business mailing address

8472 VALLEY VIEW ST
BUENA PARK CA
90620-2740
US

V. Phone/Fax

Practice location:
  • Phone: 310-935-2238
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: