Organization
FRED P. GUARCELLO & PETER S. KLEM PTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED PAUL GUARCELLO O.D. (PARTNER)
(916) 773-1195
Entity
Organization
Contact information
Practice address
1263 PLEASANT GROVE BLVD, SUITE 100, ROSEVILLE, CA 95747-5884
(916) 773-1195
(916) 773-1187
Mailing address
1263 PLEASANT GROVE BLVD, SUITE 100, ROSEVILLE, CA 95747-5884
(916) 773-1195
(916) 773-1187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6453T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0064530
—
CA
Enumeration date
09/26/2007
Last updated
02/01/2013
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