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Organization
PETER S. KLEM FRED P. GUARCELLO PTR
Active
Organization
PETER S. KLEM FRED P. GUARCELLO PTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED PAUL GUARCELLO O.D. (PARTNER)
(209) 527-7784
Entity
Organization
Contact information
Practice address
4028 DALE ROAD, SUITE 102, MODESTO, CA 95356-9561
(209) 527-7784
(209) 527-5079
Mailing address
4028 DALE ROAD, SUITE 102, MODESTO, CA 95356-9561
(209) 527-7784
(209) 527-5079
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366600082
—
CA
Enumeration date
05/29/2008
Last updated
06/15/2011
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