Provider Demographics
NPI:1417263658
Name:DEGUZMAN, RHIAN EDWARD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RHIAN
Middle Name:EDWARD
Last Name:DEGUZMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2740 S BRISTOL ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6233
Mailing Address - Country:US
Mailing Address - Phone:714-979-5734
Mailing Address - Fax:714-979-7157
Practice Address - Street 1:2740 S BRISTOL ST STE 208
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6233
Practice Address - Country:US
Practice Address - Phone:714-979-5734
Practice Address - Fax:714-979-7157
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21085363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical