Healthcare Provider Details

I. General information

NPI: 1609196724
Provider Name (Legal Business Name): MATHEW R GUGGENBILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

34800 BOB WILSON DR
SAN DIEGO CA
92134-1098
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7549
  • Fax: 619-532-5241
Mailing address:
  • Phone: 619-532-7549
  • Fax: 619-532-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.098141
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: