Provider Demographics
NPI:1689688442
Name:GUSLAND, CORY B (MD)
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:B
Last Name:GUSLAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:217 W CENTRAL AVE STE G
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-2830
Mailing Address - Country:US
Mailing Address - Phone:805-735-4292
Mailing Address - Fax:805-735-4293
Practice Address - Street 1:1101 E OCEAN AVE STE B
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7096
Practice Address - Country:US
Practice Address - Phone:805-740-9400
Practice Address - Fax:805-741-2640
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2023-11-02
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Provider Licenses
StateLicense IDTaxonomies
CAG50581207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG50581CMedicare PIN