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General NPI Number Information
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NPI Number | 1215293303
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Entity Type | Organization
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Legal Business Name | MICHAEL GUICE MD INC
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD 1509
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City | LOS ANGELES
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State | CA
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Zip | 90017-3901
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Country | US
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Telephone | 213-482-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 1127 WILSHIRE BLVD. 1509
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City | LOS ANGELES
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State | CA
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Zip | 90017-4006
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Country | US
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Telephone | 213-482-8600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL JAMES GUICE
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Credential | M.D.
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Telephone | 213-482-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G33573
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License Number State | CA
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