MEDICARE: SHANITA GUY NP

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	363L00000X	Nurse Practitioner	95018935	CA

General Provider Information

NPI Number	:	1841088473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANITA GUY NP

Provider Business Mailing Address
First Line	:	16129 HAWTHORNE BLVD STE D1022
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-2928
Country	:	US
Telephone Number	:	310-946-3840
Fax Number	:

Provider Business Practice Location Address
First Line	:	8880 S BROADWAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90003-3635
Country	:	US
Telephone Number	:	323-750-1196
Fax Number	:

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

Provider Enumeration Date	:	04/25/2025
Last Update Date	:	04/25/2025

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Directions to “ SHANITA GUY NP” Practice Location

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