Provider Demographics
NPI:1710949144
Name:GUERRA, ALDO BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALDO
Middle Name:BENJAMIN
Last Name:GUERRA
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 1:6036 N 19TH AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-2106
Mailing Address - Country:US
Mailing Address - Phone:602-246-3223
Mailing Address - Fax:602-249-1282
Practice Address - Street 1:6036 N 19TH AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2106
Practice Address - Country:US
Practice Address - Phone:602-246-3223
Practice Address - Fax:602-249-1282
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31587208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH71034Medicare UPIN