Provider Demographics
NPI:1619922291
Name:GUO, SYDNEY SHUO-YI (MD)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:SHUO-YI
Last Name:GUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NORTH BRENT STREET
Mailing Address - Street 2:STE 201
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-643-3330
Mailing Address - Fax:805-643-3331
Practice Address - Street 1:100 NORTH BRENT STREET
Practice Address - Street 2:STE 201
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-643-3330
Practice Address - Fax:805-643-3331
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012397262086S0129X, 208600000X, 174400000X
CAA683972086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010280338Medicaid
VA010280338Medicaid
VAI27623Medicare UPIN