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General NPI Number Information
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NPI Number | 1932186913
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Entity Type | Organization
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Legal Business Name | LOIDA V. GUEVARRA, M.D., INC.
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 12760 HESPERIA RD SUITE A
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City | VICTORVILLE
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State | CA
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Zip | 92395-5806
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Country | US
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Telephone | 760-955-1166
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Fax | 760-955-1499
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Provider Business Mailing Address
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Address Line | 12760 HESPERIA RD SUITE A
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City | VICTORVILLE
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State | CA
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Zip | 92395-5806
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Country | US
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Telephone | 760-955-1166
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Fax | 760-955-1499
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOIDA V GUEVARRA
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Credential | M.D.
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Telephone | 760-955-1166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A53408
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License Number State | CA
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