Provider Demographics
NPI:1760630123
Name:GUO'S MEDICAL CLINIC, LLC
Entity Type:Organization
Organization Name:GUO'S MEDICAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XIAOQING
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-781-1560
Mailing Address - Street 1:1465 HAW CREEK CIR
Mailing Address - Street 2:SUITE 703
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6577
Mailing Address - Country:US
Mailing Address - Phone:770-781-1560
Mailing Address - Fax:770-781-1561
Practice Address - Street 1:1465 HAW CREEK CIR
Practice Address - Street 2:SUITE 703
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6577
Practice Address - Country:US
Practice Address - Phone:770-781-1560
Practice Address - Fax:770-781-1561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051554207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty