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General NPI Number Information
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NPI Number | 1235878208
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Entity Type | Organization
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Legal Business Name | SAGIE DE GUZMAN LLC
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Dates
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Enumeration Date | 05/29/2022
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Last Update Date | 05/29/2022
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Provider Practice Location Address
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Address Line | 729 S HOBART BLVD APT 10
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City | LOS ANGELES
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State | CA
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Zip | 90005-2839
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Country | US
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Telephone | 213-268-5414
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Fax |
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Provider Business Mailing Address
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Address Line | 729 S HOBART BLVD APT 10
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City | LOS ANGELES
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State | CA
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Zip | 90005-2839
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Country | US
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Telephone | 213-268-5414
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Fax |
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Authorized Official
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Title or Position | NP
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Name | DR. SAGIE DE GUZMAN
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Credential | PHD
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Telephone | 213-268-5414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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