Provider Demographics
NPI:1982680781
Name:DE GUZMAN, NELSON CONCEPCION (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:CONCEPCION
Last Name:DE 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 1:11481 SONORA TRL
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8741
Mailing Address - Country:US
Mailing Address - Phone:530-549-6691
Mailing Address - Fax:530-226-7568
Practice Address - Street 1:351 HARTNELL AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1845
Practice Address - Country:US
Practice Address - Phone:530-226-7524
Practice Address - Fax:530-226-7568
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine