Provider Demographics
NPI:1679100614
Name:GUZDAR, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GUZDAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 276950
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-6950
Mailing Address - Country:US
Mailing Address - Phone:866-681-0738
Mailing Address - Fax:916-854-3769
Practice Address - Street 1:101 ROWLAND WAY STE 200
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5056
Practice Address - Country:US
Practice Address - Phone:415-878-7200
Practice Address - Fax:415-369-1387
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA185363207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine