Provider Demographics
NPI:1932690666
Name:SAGUN, GERMEL DE GUZMAN
Entity Type:Individual
Prefix:
First Name:GERMEL
Middle Name:DE GUZMAN
Last Name:SAGUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 PACHINO CIR APT G
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6531
Mailing Address - Country:US
Mailing Address - Phone:415-481-5515
Mailing Address - Fax:
Practice Address - Street 1:1550 PACHINO CIR APT G
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-6531
Practice Address - Country:US
Practice Address - Phone:415-481-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030421163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical