MEDICARE: MS. CARMELEENE SUAREZ BAGUIO N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WN0300X	Nephrology Registered Nurse	RN324700	CA

General Provider Information

NPI Number	:	1053465625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARMELEENE SUAREZ BAGUIO N.P.

Provider Business Mailing Address
First Line	:	4361 LATHAM ST
Second Line	:	SUITE 150
City	:	RIVERSIDE
State	:	CA
Zip	:	92501-1730
Country	:	US
Telephone Number	:	951-680-9717
Fax Number	:	951-680-9327

Provider Business Practice Location Address
First Line	:	36243 INLAND VALLEY DR
Second Line	:	110
City	:	WILDOMAR
State	:	CA
Zip	:	92595-9549
Country	:	US
Telephone Number	:	951-600-7630
Fax Number	:	951-600-7164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/08/2007

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