Provider Demographics
NPI:1659726206
Name:GUIDRY, KAISHAUNA (MD, HMDC)
Entity Type:Individual
Prefix:
First Name:KAISHAUNA
Middle Name:
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:MD, HMDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39252 WINCHESTER RD STE 107-177
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-3509
Mailing Address - Country:US
Mailing Address - Phone:951-293-4530
Mailing Address - Fax:413-269-8033
Practice Address - Street 1:670 N MCCARTHY BLVD STE 220
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5119
Practice Address - Country:US
Practice Address - Phone:408-964-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA155393208D00000X, 207RH0002X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program