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Individual
MR. JOSE LUIS GUEVARA JR.
Active
Individual
MR. JOSE LUIS GUEVARA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
225400000X
Rehabilitation Practitioner
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
06/05/2023
Last updated
07/28/2023
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