Organization
LOIDA V. GUEVARRA, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOIDA V GUEVARRA M.D. (PRESIDENT)
(760) 955-1166
Entity
Organization
Contact information
Practice address
12760 HESPERIA RD, SUITE A, VICTORVILLE, CA 92395-5806
(760) 955-1166
(760) 955-1499
Mailing address
12760 HESPERIA RD, SUITE A, VICTORVILLE, CA 92395-5806
(760) 955-1166
(760) 955-1499
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A53408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A534080
—
CA
01
—
01991-0023
PACIFICARE
CA
01
—
046950
HEALTHNET
CA
01
—
05256000004
IVHP
CA
01
—
805219
AETNA
CA
01
—
A53408
BLUE SHIELD
CA
Enumeration date
12/29/2005
Last updated
07/14/2010
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