Provider Demographics
NPI:1285358663
Name:DE GUZMAN ENTERPRISE INC.
Entity type:Organization
Organization Name:DE GUZMAN ENTERPRISE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-552-1388
Mailing Address - Street 1:3355 MISSION AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1327
Mailing Address - Country:US
Mailing Address - Phone:442-333-4640
Mailing Address - Fax:805-892-7300
Practice Address - Street 1:3355 MISSION AVE STE 113
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1327
Practice Address - Country:US
Practice Address - Phone:442-333-4640
Practice Address - Fax:805-892-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care