Provider Demographics
NPI:1487073375
Name:GUTH, DIANA S (RRT)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:S
Last Name:GUTH
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:DBA HOME
Other - Middle Name:RESPIRATORY
Other - Last Name:CARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2370 WESTWOOD BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2181
Mailing Address - Country:US
Mailing Address - Phone:310-441-4640
Mailing Address - Fax:310-441-4642
Practice Address - Street 1:2370 WESTWOOD BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2181
Practice Address - Country:US
Practice Address - Phone:310-441-4640
Practice Address - Fax:310-441-4642
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103600332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CART0103620Medicaid
1598760266OtherNPI
1161510001Medicare NSC