Provider Demographics
NPI:1275521494
Name:GUZMAN, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 WILSHIRE BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3550
Mailing Address - Country:US
Mailing Address - Phone:213-483-1800
Mailing Address - Fax:213-483-1494
Practice Address - Street 1:2010 WILSHIRE BLVD STE 302
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3550
Practice Address - Country:US
Practice Address - Phone:213-483-1800
Practice Address - Fax:213-483-1494
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC151747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41606Medicare ID - Type Unspecified
FLE36352Medicare UPIN