Individual
MR. MICHAEL GAVIN DEGUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12712 HEACOCK ST STE 3, MORENO VALLEY, CA 92553-3037
(951) 601-6802
(951) 601-9263
Mailing address
PO BOX 4434, RANCHO CUCAMONGA, CA 91729-4434
(909) 466-5266
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 14892
CA
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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