Provider Demographics
NPI:1134150881
Name:GUANZON, JOSE MARIA GUANZON (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE MARIA
Middle Name:GUANZON
Last Name:GUANZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2395 MONTPELIER DR
Mailing Address - Street 2:#4
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1619
Mailing Address - Country:US
Mailing Address - Phone:408-272-3041
Mailing Address - Fax:408-272-3068
Practice Address - Street 1:2395 MONTPELIER DR
Practice Address - Street 2:#4
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1619
Practice Address - Country:US
Practice Address - Phone:408-272-3041
Practice Address - Fax:408-272-3068
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA46670207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE19014Medicare UPIN
CA00A466700Medicare ID - Type Unspecified