MEDICARE: DR. ISABEL GUERRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	15809	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497758007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISABEL GUERRA M.D.

Provider Business Mailing Address
First Line	:	3003 N CENTRAL AVE
Second Line	:	STE 400
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2902
Country	:	US
Telephone Number	:	602-997-0484
Fax Number	:	602-944-6882

Provider Business Practice Location Address
First Line	:	3003 N CENTRAL AVE
Second Line	:	STE T100
City	:	PHOENIX
State	:	AZ
Zip	:	85012-0000
Country	:	US
Telephone Number	:	602-263-5446
Fax Number	:	602-263-7722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	08/01/2007

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