Active NPI
Gregory Dino Guillermo, LAC
- Acupuncturist
- Poway, CA
National Provider Identifier
1154685774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC13039
- Practice address
- 15644 Pomerado Rd Ste 400
Poway, CA 92064-2418 - Phone
- (858) 312-1672
- Fax
- (858) 312-6421
- NPI assigned
- Jun 28, 2012
- Last updated
- Jun 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC13039 | CA | Primary |
Addresses
Primary practice location
15644 Pomerado Rd Ste 400
Poway, CA 92064-2418
Mailing address
1547 E Washington Ave Apt 3
El Cajon, CA 92019-2558
Phone (619) 507-6783
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC13039 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1154685774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1547 E WASHINGTON AVE APT 3",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920192558",
"telephone_number": "619-507-6783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15644 POMERADO RD STE 400",
"city": "POWAY",
"state": "CA",
"postal_code": "920642418",
"telephone_number": "858-312-1672",
"fax_number": "858-312-6421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUILLERMO",
"first_name": "GREGORY",
"middle_name": "DINO",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-28",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC13039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.