Provider Demographics
NPI:1760672299
Name:GUIFFRE, DEBRA YVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:YVONNE
Last Name:GUIFFRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-5309
Mailing Address - Country:US
Mailing Address - Phone:760-519-9622
Mailing Address - Fax:760-758-6295
Practice Address - Street 1:5610 LAKE VISTA DR.
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-5309
Practice Address - Country:US
Practice Address - Phone:760-519-9622
Practice Address - Fax:760-758-6295
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG 61369207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF18621Medicare UPIN