Provider Demographics
NPI:1184653628
Name:GUZMAN, JULIO V (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:V
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4214 BEVERLY BLVD
Mailing Address - Street 2:212
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4479
Mailing Address - Country:US
Mailing Address - Phone:213-385-9912
Mailing Address - Fax:213-385-9915
Practice Address - Street 1:4214 BEVERLY BLVD
Practice Address - Street 2:212
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-4479
Practice Address - Country:US
Practice Address - Phone:213-385-9912
Practice Address - Fax:213-385-9915
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA066211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA66211AMedicare ID - Type UnspecifiedPROVIDER MEDICARE
CAG98658Medicare UPIN