Healthcare Provider Details

I. General information

NPI: 1801752068
Provider Name (Legal Business Name): YUGUO GUO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 HARBOR BLVD STE D220
COSTA MESA CA
92627-5864
US

IV. Provider business mailing address

2200 HARBOR BLVD STE D220
COSTA MESA CA
92627-5864
US

V. Phone/Fax

Practice location:
  • Phone: 626-413-7599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number40188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: