Healthcare Provider Details

I. General information

NPI: 1619997871
Provider Name (Legal Business Name): ALMA DELIA GUERRERO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SAN FERNANDO RD.
SAN FERNANDO CA
91340
US

IV. Provider business mailing address

10833 LE CONTE AVE 12-358 MDCC
LOS ANGELES CA
90095
US

V. Phone/Fax

Practice location:
  • Phone: 818-365-8086
  • Fax: 818-898-4826
Mailing address:
  • Phone: 310-267-2789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA91517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: