Provider Demographics
NPI:1659263275
Name:GUZMAN, BENJAMIN ERNESTO
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ERNESTO
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7248 JOSHUA LN
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2923
Mailing Address - Country:US
Mailing Address - Phone:951-394-1261
Mailing Address - Fax:
Practice Address - Street 1:7248 JOSHUA LN
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2923
Practice Address - Country:US
Practice Address - Phone:951-394-1261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker