Provider Demographics
NPI:1265476162
Name:GUERRERO, ANNETTE M (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:GUERRERO
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 1:7643 PAINTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2393
Mailing Address - Country:US
Mailing Address - Phone:562-464-5350
Mailing Address - Fax:562-464-0943
Practice Address - Street 1:7643 PAINTER AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2393
Practice Address - Country:US
Practice Address - Phone:562-464-5350
Practice Address - Fax:562-464-0943
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64097207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01272665/DU4032OtherRAILROAD MEDICARE
CA00G640970Medicaid
CA00G640970OtherMEDI-CAL
CAWG64097EMedicare PIN
CABX372UMedicare PIN
E57401Medicare UPIN
CABH372SMedicare PIN
CABH372QMedicare PIN
CA00G640970OtherMEDI-CAL
CABH372XMedicare PIN
CABX372YMedicare PIN
CAWG64097DMedicare PIN
CAWG64097FMedicare PIN
CAWG64097GMedicare PIN
CABH372RMedicare PIN
CAP01272665/DU4032OtherRAILROAD MEDICARE
CAWG64097CMedicare PIN
CAWG64097HMedicare PIN