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General NPI Number Information
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NPI Number | 1609892611
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Entity Type | Organization
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Legal Business Name | DONALD J GUIDO OD INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 2248 D ST
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City | LA VERNE
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State | CA
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Zip | 91750-5403
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Country | US
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Telephone | 909-593-3519
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Fax | 909-593-3521
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Provider Business Mailing Address
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Address Line | 2248 D ST
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City | LA VERNE
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State | CA
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Zip | 91750-5403
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Country | US
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Telephone | 909-593-3519
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Fax | 909-593-3521
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD J GUIDO
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Credential | O.D.
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Telephone | 909-593-3519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 7205T
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License Number State | CA
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