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General NPI Number Information
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NPI Number | 1720186786
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Entity Type | Organization
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Legal Business Name | GUADALUPE C. PEDRANO, M.D., INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 2209 N SAN FERNANDO RD
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City | LOS ANGELES
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State | CA
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Zip | 90065-1231
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Country | US
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Telephone | 323-226-0511
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Fax | 323-221-5247
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Provider Business Mailing Address
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Address Line | 2209 N SAN FERNANDO RD
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City | LOS ANGELES
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State | CA
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Zip | 90065-1231
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Country | US
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Telephone | 323-226-0511
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Fax | 323-221-5247
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUADALUPE CRUZ PEDRANO
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Credential | M.D.
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Telephone | 323-226-0511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A40246
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License Number State | CA
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