Provider Demographics
NPI:1932886587
Name:WANG, KARLA DE GUZMAN (PA-C)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:DE GUZMAN
Last Name:WANG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:851 GOV CARLOS G CAMACHO RD
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3153
Mailing Address - Country:US
Mailing Address - Phone:671-649-5018
Mailing Address - Fax:
Practice Address - Street 1:851 GOV CARLOS G CAMACHO RD
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3153
Practice Address - Country:US
Practice Address - Phone:671-649-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-04
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant