Provider Demographics
NPI:1174786073
Name:PEDRANO, GUADALUPE CRUZ (MD)
Entity type:Individual
Prefix:DR
First Name:GUADALUPE
Middle Name:CRUZ
Last Name:PEDRANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GUADALUPE
Other - Middle Name:PEDRANO
Other - Last Name:FLORESCIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2209 N SAN FERNANDO RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-1231
Mailing Address - Country:US
Mailing Address - Phone:323-226-0511
Mailing Address - Fax:323-221-5247
Practice Address - Street 1:2209 N SAN FERNANDO RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-1231
Practice Address - Country:US
Practice Address - Phone:323-226-0511
Practice Address - Fax:323-221-5247
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40246208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice