Provider Demographics
NPI:1710054788
Name:GUERREIRO, FRANCES DEGREGORIO (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:DEGREGORIO
Last Name:GUERREIRO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:FRANCES
Other - Middle Name:
Other - Last Name:DEGREGORIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2121 SPEYER LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4917
Mailing Address - Country:US
Mailing Address - Phone:310-308-8356
Mailing Address - Fax:
Practice Address - Street 1:1720 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5601
Practice Address - Country:US
Practice Address - Phone:310-539-4363
Practice Address - Fax:310-539-4664
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10685TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0106850Medicaid
U75614Medicare UPIN
CAWOP10685AMedicare ID - Type Unspecified