Individual provider · NPI-1

Conrado Jr Guadiz

Nurse Practitioner, Family · La Habra, CA

NPI number1942937768
StatusActive
Last updated in NPPESAug 23, 2023

Details

NPI
1942937768
Entity type
Individual (NPI-1)
Name
Mr. Conrado Jr Guadiz
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 2, 2022
Certification date
Aug 23, 2023
Last updated
Aug 23, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family95021714CAYes

Practice location

1250 W Marigold Ave
La Habra, CA 90631-9249

Phone 714-603-5118

Mailing address

1250 W Marigold Ave
La Habra, CA 90631-9249

Phone 714-603-5118

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