Provider Demographics
NPI:1073794152
Name:GUARDADO, ESTHER (PAC)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:GUARDADO
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S IDAHO ST STE 100
Mailing Address - Street 2:100
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6047
Mailing Address - Country:US
Mailing Address - Phone:562-690-0400
Mailing Address - Fax:
Practice Address - Street 1:501 S IDAHO ST
Practice Address - Street 2:100
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631
Practice Address - Country:US
Practice Address - Phone:562-690-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-17
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17635363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant