Individual
GUILLERMO M GUZMAN TREVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4424 E FLAMINGO, SUITE 200, NAMPA, ID 83687-9300
(208) 288-4888
(208) 288-4890
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-12168
ID
207V00000X
Obstetrics & Gynecology Physician
MD-29170
OR
207V00000X
Obstetrics & Gynecology Physician
MD29170
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500609069
—
OR
01
—
808416200
IDAHO MEDICAID
ID
Enumeration date
05/01/2009
Last updated
12/09/2014
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