Individual provider Active NPI

Jessie Guerrero, MD

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1053989921
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414
Phone
(323) 260-5781
NPI assigned
Jun 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414

Mailing address

18355 Collins St Apt 124
Tarzana, CA 91356-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213000750 CA Practitioner - Family Practice 6507392545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Community HealthcareGroup PAC ID 4284601824, 23 clinicians

Practice addresses (Care Compare)

6801 Coldwater Canyon Ave
North Hollywood, CA 91605-5162
Phone (818) 301-6307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Community Healthcare Multi-Specialty CurrentSince Sep 16, 2024 Accepting new patients
Valley Community Healthcare Multi-Specialty CurrentSince Sep 16, 2024 Accepting new patients

Locations

6801 Coldwater Canyon Ave
North Hollywood, CA 91605
Phone (818) 301-6307

13400 Riverside Dr
Ste 300
Sherman Oaks, CA 91423
Phone (310) 275-1867

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1053989921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18355 COLLINS ST APT 124",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332414",
            "telephone_number": "323-260-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "JESSIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.