Provider Demographics
NPI:1225865298
Name:GUZMAN, CHANSAMAY
Entity type:Individual
Prefix:
First Name:CHANSAMAY
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 SWEETWATER AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-7703
Mailing Address - Country:US
Mailing Address - Phone:412-639-1459
Mailing Address - Fax:
Practice Address - Street 1:640 W 20TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-3702
Practice Address - Country:US
Practice Address - Phone:209-238-7588
Practice Address - Fax:209-238-7588
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)