Provider Demographics
NPI:1497098966
Name:SHIREEN V. GUIDE, M.D., INC.
Entity Type:Organization
Organization Name:SHIREEN V. GUIDE, M.D., INC.
Other - Org Name:MISSION DERMATOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHIREEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:GUIDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-485-1333
Mailing Address - Street 1:30 CALLE AVEITUNA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-7000
Mailing Address - Country:US
Mailing Address - Phone:949-485-1333
Mailing Address - Fax:949-259-0010
Practice Address - Street 1:29829 SANTA MARGARITA PKWY
Practice Address - Street 2:SUITE 500
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3622
Practice Address - Country:US
Practice Address - Phone:949-858-3376
Practice Address - Fax:949-259-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95744207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty