Provider Demographics
NPI:1316662091
Name:GUZMAN, EDDIE (AUD)
Entity type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 W ELM AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2707
Mailing Address - Country:US
Mailing Address - Phone:714-681-6808
Mailing Address - Fax:
Practice Address - Street 1:11360 183RD ST
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5419
Practice Address - Country:US
Practice Address - Phone:562-809-2167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3743231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist