MEDICARE: DAISY ELIZABETH GUERRA RDN

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	133V00000X	Registered Dietitian	86174602	CA

General Provider Information

NPI Number	:	1639965775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAISY ELIZABETH GUERRA RDN

Provider Business Mailing Address
First Line	:	11430 BURBANK BLVD UNIT 508
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2359
Country	:	US
Telephone Number	:	747-272-7171
Fax Number	:

Provider Business Practice Location Address
First Line	:	11430 BURBANK BLVD UNIT 508
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2359
Country	:	US
Telephone Number	:	747-272-7171
Fax Number	:

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

Provider Enumeration Date	:	04/16/2025
Last Update Date	:	04/16/2025

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