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NPI Code Detail

MEDICARE: ISAIAS DE GUZMAN PAJA JR. MD INC

MEDICARE: ISAIAS DE GUZMAN PAJA JR. MD INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/CenterCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053367896
Entity Type Code : Organization
Provider Name (Legal Business Name) : ISAIAS DE GUZMAN PAJA JR. MD INC
Provider Business Mailing Address
First Line : 1800 WILSHIRE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3602
Country : US
Telephone Number : 213-484-9934
Fax Number : 213-484-9939
Provider Business Practice Location Address
First Line : 1800 WILSHIRE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3602
Country : US
Telephone Number : 213-484-9934
Fax Number : 213-484-9939
Authorized Official
Title or Position : OWNER
Name : ISAIAS PAJA
Credential : A56363
Telephone Number : 213-484-9934
Provider Enumeration Date : 05/25/2006
Last Update Date : 08/23/2024

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