Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | A140362 | CA |
NPI | 1407273345 |
---|---|
Provider Name | Robert Daniel Guglielmo |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Los Angeles, CA 90027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 19/08/2019 |