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General NPI Number Information
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NPI Number | 1275954711
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Entity Type | Organization
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Legal Business Name | SAN FERNANDO WEST KIDNEY CENTER L.P
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Dates
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Enumeration Date | 12/31/2013
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 7230 MEDICAL CENTER DR STE 101
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City | WEST HILLS
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State | CA
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Zip | 91307-4001
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Country | US
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Telephone | 818-888-4730
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Fax | 818-888-3460
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Provider Business Mailing Address
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Address Line | 7230 MEDICAL CENTER DR STE 205
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City | WEST HILLS
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State | CA
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Zip | 91307-4007
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Country | US
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Telephone | 818-345-0664
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Fax | 818-657-0131
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Authorized Official
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Title or Position | MANAGER
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Name | LAWRENCE P GUZIEL
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Credential | M.D
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Telephone | 818-345-0664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 261QE0700X
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License Number State | CA
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