Individual
ALICIA AMELIA GUEVARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
248 HAMPSHIRE RD STE 100, THOUSAND OAKS, CA 91361-2401
(805) 370-0040
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A95110
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A95110
STATE LICENSE
CA
Enumeration date
04/18/2007
Last updated
10/04/2023
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