Melissa De Guzman Duag, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16460 Issued in CA

Practice address

9436 E. Slauson Avenue
Pico Rivera, CA 90660-4748

Phone

(562) 949-6069

Fax

(562) 949-0199

NPI assigned

Nov 27, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Melissa Tabanera De Guzman Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1063588507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9436 E. SLAUSON AVENUE",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604748",
            "telephone_number": "562-949-6069",
            "fax_number": "562-949-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9436 E. SLAUSON AVENUE",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604748",
            "telephone_number": "562-949-6069",
            "fax_number": "562-949-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUAG",
        "first_name": "MELISSA",
        "middle_name": "DE GUZMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DE GUZMAN",
            "middle_name": "TABANERA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Pico Rivera, CA
• Providers in Pico Rivera, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.