MEDICARE: JULIO V GUZMAN MD

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
1	207Q00000X	Family Medicine Physician	A066211	CA

General Provider Information

NPI Number	:	1184653628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIO V GUZMAN MD

Provider Business Mailing Address
First Line	:	4214 BEVERLY BLVD
Second Line	:	212
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4479
Country	:	US
Telephone Number	:	213-385-9912
Fax Number	:	213-385-9915

Provider Business Practice Location Address
First Line	:	4214 BEVERLY BLVD
Second Line	:	212
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4479
Country	:	US
Telephone Number	:	213-385-9912
Fax Number	:	213-385-9915

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/09/2007

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