Provider Demographics
NPI:1821886250
Name:GUO, MIKE YITAO
Entity type:Individual
Prefix:
First Name:MIKE
Middle Name:YITAO
Last Name:GUO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:YITAO
Other - Middle Name:
Other - Last Name:GUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:857 TOYON CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-1154
Mailing Address - Country:US
Mailing Address - Phone:408-966-6919
Mailing Address - Fax:
Practice Address - Street 1:2570 48TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1541
Practice Address - Country:US
Practice Address - Phone:916-734-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program