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NPI Code Detail

MEDICARE: ROGELIO ISRAEL GUILLEN I

MEDICARE: ROGELIO ISRAEL GUILLEN I
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
1103K00000XBehavior Analyst1-18-29618CA

General Provider Information

NPI Number : 1710288808
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGELIO ISRAEL GUILLEN I
Provider Business Mailing Address
First Line : 6160 CORNERSTONE CT E STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3724
Country : US
Telephone Number : 858-304-6440
Fax Number :
Provider Business Practice Location Address
First Line : 6160 CORNERSTONE CT E STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3724
Country : US
Telephone Number : 858-304-6440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2010
Last Update Date : 08/08/2023

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Directions to “ ROGELIO ISRAEL GUILLEN I ” Practice Location

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