Healthcare Provider Details

I. General information

NPI: 1881564342
Provider Name (Legal Business Name): HOSPITAL SAN JOSE DE GUAYMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MARIA ALBERTO CONTRERAS ZAVALA BLVD MANLIO FABIO BELTRONES 100
GUAYMAS SONORA
85500
MX

IV. Provider business mailing address

625 KENMOOR AVE SE STE 301
GRAND RAPIDS MI
49546-2395
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. JAVIER EZQUERRA
Title or Position: MANAGER
Credential: MD
Phone: 801-896-1181