Provider Demographics
NPI:1811064728
Name:GUEST, RICHARD A (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:GUEST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:POB 12325
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91224-5325
Mailing Address - Country:US
Mailing Address - Phone:310-507-5099
Mailing Address - Fax:
Practice Address - Street 1:18250 ROSCOE BLVD
Practice Address - Street 2:SUITE 335
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4216
Practice Address - Country:US
Practice Address - Phone:818-998-8591
Practice Address - Fax:818-998-1196
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2016-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA336852086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB247613Medicare UPIN