Individual
CARLOS A GUANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18370 BURBANK BLVD STE 100, TARZANA, CA 91356-2818
(424) 314-7630
Mailing address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
(818) 997-7826
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G87050
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
G87050
CA
Other
Enumeration date
07/03/2006
Last updated
12/22/2023
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