Provider Demographics
NPI:1093790206
Name:GUERREIN, MARSHA A (MD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:A
Last Name:GUERREIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 OCEANGATE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4312
Mailing Address - Country:US
Mailing Address - Phone:562-590-7400
Mailing Address - Fax:562-590-7452
Practice Address - Street 1:410 TORRANCE BOULEVARD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-540-7676
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA396872085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A396870OtherMEDI CAL
CA00A396870OtherMEDI CAL