Organization Active NPI

Benny J Guzman M D Corporation

  • Student in an Organized Health Care Education/Training Program
  • Chino Hills, CA
National Provider Identifier
1487742979
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
A72290 Issued in CA
Legal business name
BENNY J GUZMAN M D CORPORATION
Practice address
5827 Pine Ave
Suite a
Chino Hills, CA 91709-6534
Phone
(909) 613-0016
Fax
(909) 613-0026
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Benny Guzman, MD
Title
Ceo
Phone
(909) 613-0016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X A72290 CA Primary

Addresses

Primary practice location

5827 Pine Ave
Suite a
Chino Hills, CA 91709-6534

Mailing address

5827 Pine Ave Ste a
Chino Hills, CA 91709-6534
Phone (909) 613-0016

Other identifiers 2

IdentifierTypeStateIssuer
00A722901MedicaidCA
00A722900MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070815000839 CA Part B Supplier - Clinic/Group Practice 8527150903 Practice locations: Chino Hills, CA; Fontana, CA

National Provider Directory

National Provider Directory

Locations

3580 Grand Ave
Ste G
Chino Hills, CA 91709
Phone (909) 465-1809

3580 Grand Ave
Ste A
Chino Hills, CA 91709

16127 Foothill Blvd
Fontana, CA 92335
Phone (909) 347-0700

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1487742979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 PINE AVE STE A",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096534",
            "telephone_number": "909-613-0016",
            "fax_number": "909-613-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5827 PINE AVE",
            "address_2": "SUITE A",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096534",
            "telephone_number": "909-613-0016",
            "fax_number": "909-613-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNY J GUZMAN M D CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "BENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-613-0016",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A72290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A722901",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A722900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.