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Organization

GUADALUPE MEDICAL GROUP A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TEODULO CRUZ BONZON LCSW (OPERATING PROVIDER)
(818) 846-4469
Entity
Organization

Contact information

Practice address
4201 E 10TH ST, LONG BEACH, CA 90804-5508
(323) 543-4535
(323) 480-4574
Mailing address
4525 EAGLE ROCK BLVD, LOS ANGELES, CA 90041-3214
(818) 846-4469

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
07/20/2026
Last updated
07/20/2026
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