Provider Demographics
NPI:1134307606
Name:FRANK GUERRA MD PC
Entity Type:Organization
Organization Name:FRANK GUERRA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-440-2456
Mailing Address - Street 1:1155 ALPINE AVE STE 385
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3495
Mailing Address - Country:US
Mailing Address - Phone:303-440-2456
Mailing Address - Fax:303-440-2427
Practice Address - Street 1:1155 ALPINE AVE STE 385
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3495
Practice Address - Country:US
Practice Address - Phone:303-440-2456
Practice Address - Fax:303-440-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD60849Medicare UPIN
COC497758Medicare PIN