Provider Demographics
NPI:1255665824
Name:GUIDRY, PAUL LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:LEE
Last Name:GUIDRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4343 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4929
Mailing Address - Country:US
Mailing Address - Phone:323-299-1275
Mailing Address - Fax:323-299-2149
Practice Address - Street 1:4343 CRENSHAW BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-4929
Practice Address - Country:US
Practice Address - Phone:323-299-1275
Practice Address - Fax:323-299-2149
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine