Provider Demographics
NPI:1982610887
Name:GUZMAN, EDUARDO J (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:J
Last Name: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 1:11514 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3802
Mailing Address - Country:US
Mailing Address - Phone:562-929-9999
Mailing Address - Fax:562-929-0891
Practice Address - Street 1:11514 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3802
Practice Address - Country:US
Practice Address - Phone:562-929-9999
Practice Address - Fax:562-929-0891
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50344207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA954622498OtherCOMMERCIAL PLANS
CAWA502441OtherMEDICARE PTAN
CA00A503444Medicaid
CAA050344BOtherMEDICARE PTAN
CA00A503441Medicaid
CA00A503441Medicaid