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General NPI Number Information
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NPI Number | 1598760266
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Entity Type | Organization
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Legal Business Name | DIANA S. GUTH
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 2370 WESTWOOD BLVD STE D
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City | LOS ANGELES
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State | CA
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Zip | 90064-2120
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Country | US
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Telephone | 310-441-4640
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Fax | 310-441-4642
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Provider Business Mailing Address
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Address Line | 2370 WESTWOOD BLVD STE D
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City | LOS ANGELES
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State | CA
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Zip | 90064-2120
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Country | US
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Telephone | 310-441-4640
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Fax | 310-441-4642
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Authorized Official
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Title or Position | OWNER
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Name | DIANA S. GUTH
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Credential | RRT
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Telephone | 310-441-4640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 103600
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License Number State | CA
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