Healthcare Provider Details

I. General information

NPI: 1902234040
Provider Name (Legal Business Name): CALIFORNIA GUZ MEDIC ANESTHESIA SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2056 SEQUOIA CT
TROY MI
48085-3580
US

IV. Provider business mailing address

2056 SEQUOIA CT
TROY MI
48085-3580
US

V. Phone/Fax

Practice location:
  • Phone: 301-332-3609
  • Fax: 313-270-7291
Mailing address:
  • Phone: 301-332-3609
  • Fax: 313-270-7291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: JEAN NYAMBIO
Title or Position: PRESIDENT
Credential: CRNA
Phone: 301-332-3609