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General NPI Number Information
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NPI Number | 1164757456
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Entity Type | Individual
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Provider Name | HEATHER RENEE MCGUIRE D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 2961 LOMA VISTA RD
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City | VENTURA
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State | CA
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Zip | 93003-2915
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Country | US
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Telephone | 805-701-5203
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Fax |
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Provider Business Mailing Address
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Address Line | 2961 LOMA VISTA RD
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City | VENTURA
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State | CA
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Zip | 93003-2915
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Country | US
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Telephone | 805-701-5203
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | EL1741
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E 4893
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License Number State | CA
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