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Individual

DR. CHARLES CLAYTON GUIDRY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5141 CRENSHAW BLVD, LOS ANGELES, CA 90043-1853
(800) 831-4767
(909) 338-9883
Mailing address
PO BOX 55378, #4105, LOS ANGELES, CA 90055-2378
(281) 989-5952

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
248950
NY
2086S0102X
Surgical Critical Care Physician
Primary
248950
NY
2086S0127X
Trauma Surgery Physician
248950
NY

Other

Enumeration date
06/11/2009
Last updated
09/22/2016
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