Healthcare Provider Details

I. General information

NPI: 1902538101
Provider Name (Legal Business Name): BRANDON GUINVARCH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 ABBOTT ST STE 100
SALINAS CA
93901-4484
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-751-7070
  • Fax: 831-751-7050
Mailing address:
  • Phone: 831-649-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number61261
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: