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General NPI Number Information
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NPI Number | 1831211416
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Entity Type | Individual
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Provider Name | ERICK GUILLORY P. A.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 9301 WILSHIRE BLVD SUITE 404
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5424
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Country | US
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Telephone | 310-278-9171
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Fax | 310-278-2058
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Provider Business Mailing Address
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Address Line | 8162 MANITOBA ST UNIT 305
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-8641
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Country | US
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Telephone | 310-482-1453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA 13616
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License Number State | CA
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