Provider Demographics
NPI:1437128030
Name:GUO, WEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:WEN
Middle Name:L
Last Name:GUO
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 1:5576 S FORT APACHE RD. SUITE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-3602
Mailing Address - Country:US
Mailing Address - Phone:702-895-9968
Mailing Address - Fax:702-895-9928
Practice Address - Street 1:5576 S FORT APACHE RD. SUITE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-3602
Practice Address - Country:US
Practice Address - Phone:702-895-9968
Practice Address - Fax:702-895-9928
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12317207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1437128030Medicaid
NV1437128030Medicaid