Provider Demographics
NPI:1225028442
Name:GUZMAN, CARLOS E (PA-C)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 JENSEN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-2863
Mailing Address - Country:US
Mailing Address - Phone:559-875-5521
Mailing Address - Fax:559-875-2032
Practice Address - Street 1:1822 JENSEN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-2863
Practice Address - Country:US
Practice Address - Phone:559-875-5521
Practice Address - Fax:559-875-2032
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17888363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical