Individual
DIEGO JESUS GUZMAN GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13137 ADELINE AVE, MORENO VALLEY, CA 92553-5930
(626) 722-2097
Mailing address
13137 ADELINE AVE, MORENO VALLEY, CA 92553-5930
(626) 722-2097
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
OA48872
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OA48872
—
CA
Enumeration date
09/04/2018
Last updated
09/04/2018
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