Active NPI
Glenn Michael De Guzman, P.A.
- Physician Assistant
- Norwalk, CA
National Provider Identifier
1265448294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18213
- Practice address
- 13330 Bloomfield Ave Ste 111
Norwalk, CA 90650-3264 - Phone
- (562) 868-0733
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18213 | CA | Primary |
Addresses
Primary practice location
13330 Bloomfield Ave Ste 111
Norwalk, CA 90650-3264
Mailing address
19416 Cheyenne Wells Cir
Walnut, CA 91789-4371
Phone (562) 868-0733
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA18213 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Santa Ana, CA
- NPI 1548667843
-
- Emergency Medicine Physician
- Pomona, CA
- NPI 1740235258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265448294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19416 CHEYENNE WELLS CIR",
"city": "WALNUT",
"state": "CA",
"postal_code": "917894371",
"telephone_number": "562-868-0733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13330 BLOOMFIELD AVE STE 111",
"city": "NORWALK",
"state": "CA",
"postal_code": "906503264",
"telephone_number": "562-868-0733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE GUZMAN",
"first_name": "GLENN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norwalk, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.