NPIMap

Organization Active NPI

Rosalie a. de Guzman, M.D., Inc.

  • Pediatrics Physician
  • Corona, CA
National Provider Identifier
1780615864
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A39804 Issued in CA
Legal business name
ROSALIE A. DE GUZMAN, M.D., INC.
Practice address
823 S Main St
Suite 100
Corona, CA 92882-3421
Phone
(951) 270-0067
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rosalie A De Guzman, M.D.NPI 1386675452
Title
Pediatrician
Phone
(951) 270-0067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A39804 CA Primary

Addresses

Primary practice location

823 S Main St
Suite 100
Corona, CA 92882-3421

Mailing address

823 S Main St
Suite 100
Corona, CA 92882-3421
Phone (951) 270-0067

Other identifiers 1

IdentifierTypeStateIssuer
00A398040MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780615864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 S MAIN ST",
            "address_2": "SUITE 100",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823421",
            "telephone_number": "951-270-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 S MAIN ST",
            "address_2": "SUITE 100",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823421",
            "telephone_number": "951-270-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSALIE A. DE GUZMAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "ROSALIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "951-270-0067",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A39804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A398040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.