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NPI Code Detail

MEDICARE: JAMES GUERRA P.T.

MEDICARE: JAMES GUERRA P.T.
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
1225100000XPhysical TherapistPT33733CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT33733OTHERCAMEDICAL LICENSE

General Provider Information

NPI Number : 1669632212
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES GUERRA P.T.
Provider Business Mailing Address
First Line : 880 OAK PARK BLVD
Second Line : SUITE 202
City : ARROYO GRANDE
State : CA
Zip : 93420-1821
Country : US
Telephone Number : 805-473-7499
Fax Number : 805-473-7494
Provider Business Practice Location Address
First Line : 880 OAK PARK BLVD
Second Line : SUITE 202
City : ARROYO GRANDE
State : CA
Zip : 93420-1821
Country : US
Telephone Number : 805-473-7499
Fax Number : 805-473-7494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 06/16/2008

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