MEDICARE: CLIFFORD J. GUSS PA-C

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	363AM0700X	Medical Physician Assistant	2984	AZ

General Provider Information

NPI Number	:	1811966856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFFORD J. GUSS PA-C

Provider Business Mailing Address
First Line	:	5750 W THUNDERBIRD RD STE A100
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4661
Country	:	US
Telephone Number	:	602-938-3205
Fax Number	:	602-938-5799

Provider Business Practice Location Address
First Line	:	5750 W THUNDERBIRD RD STE A100
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4661
Country	:	US
Telephone Number	:	602-938-3205
Fax Number	:	602-938-5799

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	08/12/2024

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