Individual provider Active NPI

Ronald Christian Guevara Rebueno, FNP

  • Family Nurse Practitioner
  • La Puente, CA
National Provider Identifier
1104704360
Registry record updated Dec 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95036567 Issued in CA
Practice address
15115 Amar Rd
La Puente, CA 91744-1914
Phone
(626) 918-4700
NPI assigned
Aug 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95036567 CA Primary

Addresses

Primary practice location

15115 Amar Rd
La Puente, CA 91744-1914

Mailing address

15115 Amar Rd
La Puente, CA 91744-1914
Phone (626) 918-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95036567CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Perez Medical Group Inc CurrentSince Dec 28, 2025 Accepting new patients

Locations

15115 Amar Rd
La Puente, CA 91744
Phone (626) 918-4700

Organizations & group practices 1

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": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766275200000",
    "number": "1104704360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15115 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441914",
            "telephone_number": "626-918-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15115 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441914",
            "telephone_number": "626-918-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBUENO",
        "first_name": "RONALD",
        "middle_name": "CHRISTIAN GUEVARA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-12-21",
        "certification_date": "2025-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95036567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.