Individual provider Active NPI

Eddie Guzman, AUD

  • Audiologist
  • Cerritos, CA
National Provider Identifier
1316662091
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3743 Issued in CA
Practice address
11360 183Rd St
Cerritos, CA 90703-5419
Phone
(562) 809-2167
NPI assigned
Oct 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3743 CA Primary

Addresses

Primary practice location

11360 183Rd St
Cerritos, CA 90703-5419

Mailing address

629 W Elm Ave
Fullerton, CA 92832-2707
Phone (714) 681-6808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230703000927 CA Practitioner - Qualified Audiologist 4981063450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Gabriel Valley Audiology and Hearing AIDSGroup PAC ID 2163881632, 2 clinicians

Practice addresses (Care Compare)

1700 W Cameron Ave
Suite 110
West Covina, CA 91790-2718
Phone (626) 485-2634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
San Gabriel Valley Audiology and Hearing AIDS Audiologist CurrentSince Jun 1, 2023 Accepting new patients

Locations

1700 W Cameron Ave
Ste 110
West Covina, CA 91790
Phone (626) 485-2634

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1316662091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 W ELM AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322707",
            "telephone_number": "714-681-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11360 183RD ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035419",
            "telephone_number": "562-809-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "EDDIE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "3743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.