Provider Demographics
NPI:1104179563
Name:GUIRGUIS, NOHA MONIR AZIZ MIKHAEL (RDMS, RVT)
Entity Type:Individual
Prefix:
First Name:NOHA
Middle Name:MONIR AZIZ MIKHAEL
Last Name:GUIRGUIS
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 PLAYA BLANCA CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-7717
Mailing Address - Country:US
Mailing Address - Phone:714-264-9083
Mailing Address - Fax:
Practice Address - Street 1:798 PLAYA BLANCA CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-7717
Practice Address - Country:US
Practice Address - Phone:714-264-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1531662471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography