Provider Demographics
NPI:1689632614
Name:LEMIRE, GUY GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:GERARD
Last Name:LEMIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 MARINA PACIFICA DR S # 18
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3822
Mailing Address - Country:US
Mailing Address - Phone:562-972-1998
Mailing Address - Fax:562-286-8047
Practice Address - Street 1:5122 MARINA PACIFICA DR S # 18
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-3822
Practice Address - Country:US
Practice Address - Phone:562-972-1998
Practice Address - Fax:562-286-8047
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31562208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A315620Medicaid
CAB50293Medicare UPIN
CA00A315620Medicaid