Organization
LISA E. GUERRA, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA E GUERRA MD (OWNER)
(949) 764-8281
Entity
Organization
Contact information
Practice address
ONE HOAG DR., HOAG BREAST CENTER, SUE AND BILL GROSS WOMEN'S PAVILION, NEWPORT BEACH, CA 92663-4162
(949) 764-8281
(949) 764-8236
Mailing address
17501 17TH ST, SUITE 270, TUSTIN, CA 92780-7902
(949) 764-8281
(949) 764-8236
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A95743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ630B
MEDICARE PTAN
CA
Enumeration date
05/12/2008
Last updated
01/15/2014
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