Provider Demographics
NPI:1275293573
Name:HOCSON, GUADA MAE CRUZADO
Entity Type:Individual
Prefix:
First Name:GUADA MAE
Middle Name:CRUZADO
Last Name:HOCSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N BERENDO ST APT 105
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4887
Mailing Address - Country:US
Mailing Address - Phone:626-991-5553
Mailing Address - Fax:
Practice Address - Street 1:1050 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2102
Practice Address - Country:US
Practice Address - Phone:213-975-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist