Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 11191 | NV |
N | 2080P0205X | Pediatric Endocrinologist | 11191 | NV |
NPI | 1396755542 |
---|---|
Provider Name | Jocelyn B De Guzman |
First Address | Elko, NV 89801-8334 |
Second Address | Elko, NV 89801-8334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1396755542 | (05) | NV |
I26071 | (02) | NV |