# GUADALUPE MEDICAL GROUP A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932029725
- **Authorized official:** MR. TEODULO CRUZ BONZON LCSW (OPERATING PROVIDER)
- **Authorized official phone:** (818) 846-4469

## Contact information

- **Practice address:** 4201 E 10TH ST, LONG BEACH, CA 90804-5508
- **Practice address phone:** (323) 543-4535
- **Practice address fax:** (323) 480-4574
- **Mailing address:** 4525 EAGLE ROCK BLVD, LOS ANGELES, CA 90041-3214
- **Mailing address phone:** (818) 846-4469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/20/2026
- **Last updated:** 07/20/2026