Healthcare Provider Details

I. General information

NPI: 1902088636
Provider Name (Legal Business Name): ESGAR GUARIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ESGAR E GUARIN-NIETO MD

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5191 MAPLE DR STE L
PLEASANT HILL IA
50327-8455
US

IV. Provider business mailing address

5191 MAPLE DR STE L
PLEASANT HILL IA
50327-8455
US

V. Phone/Fax

Practice location:
  • Phone: 515-603-2140
  • Fax: 515-809-3702
Mailing address:
  • Phone: 515-603-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberP20838
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD13032
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2012004800
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-42659
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD 13032
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD 13032
License Number StateRI
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 13032
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: