Sandra Elizabeth De Guzman, CERTIFIED NURSE MIDW is a medicare enrolled "Midwife" in Harbor City, California. Her current practice location is
25965 Normandie Ave, Harbor City, California. You can reach out to her office (for appointments etc.) via phone at
(800) 780-1230.
Sandra Elizabeth De Guzman is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1295383602.
Provider's Profile
| Full Name | Sandra Elizabeth De Guzman |
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| Gender | Female |
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| Speciality | Midwife |
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| Location | 25965 Normandie Ave, Harbor City, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1295383602
- Provider Enumeration Date: 08/28/2019
- Last Update Date: 11/30/2021
Medicare PECOS Information:
- PECOS PAC ID: 9638503063
- Enrollment ID: I20191218000873
Medical Identifiers
Medical identifiers for Sandra Elizabeth De Guzman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295383602 | NPI | - | NPPES |
| 0 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LW0102X | Nurse Practitioner - Women's Health | 95010318 (California) | Secondary |
| 176B00000X | Midwife | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sandra Elizabeth De Guzman allows following entities to bill medicare on her behalf.
| Entity Name | Southern California Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sandra Elizabeth De Guzman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Sandra Elizabeth De Guzman, CERTIFIED NURSE MIDW
2160 Fashion Ave,
Long Beach, CA 90810-3535
Ph: (310) 334-9983 | Sandra Elizabeth De Guzman, CERTIFIED NURSE MIDW
25965 Normandie Ave,
Harbor City, CA 90710-3416
Ph: (800) 780-1230 |
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