Organization
TITA DE GUZMAN INSURANCE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TITA DE GUZMAN (CEO/LICENSEE)
(909) 348-0444
Entity
Organization
Contact information
Practice address
15319 SPINNING AVE, GARDENA, CA 90249-4143
(310) 768-8099
Mailing address
1241 GRAND AVE, SUITE H, DIAMOND BAR, CA 91765-4447
(909) 348-0444
(909) 348-0439
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
960000845
CA
Other
Enumeration date
12/18/2007
Last updated
05/21/2008
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