Pedro Deoliveira Guimaraes, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C52093 Issued in CA

Practice address

1329 Broad St
Suite a
San Luis Obispo, CA 93401-3909

Phone

(805) 540-0279

Fax

(805) 439-1070

NPI assigned

Oct 24, 2005

Last updated

Nov 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Pedro De Oliveira Guimaraes Neto Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 27, 2015 through Jul 27, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• San Diego Psychiatric Services Inc

  • Psychiatry Physician
  • Chula Vista, CA
  • NPI 1609650563
  NPD Authorized official
• Central Coast Behavioral Health, Inc.

  • Psychiatry Physician
  • Arroyo Grande, CA
  • NPI 1699112698
  NPD (past)
• Palm Desert Psychiatry Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Palm Desert, CA
  • NPI 1487277257
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1285624155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14209",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934064209",
            "telephone_number": "805-540-0279",
            "fax_number": "805-439-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 BROAD ST",
            "address_2": "SUITE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013909",
            "telephone_number": "805-540-0279",
            "fax_number": "805-439-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIMARAES",
        "first_name": "PEDRO",
        "middle_name": "DEOLIVEIRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "216516",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C52093",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "013761",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "13428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEDRO",
            "last_name": "GUIMARAES NETO",
            "middle_name": "DE OLIVEIRA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jazmin Guerra Lopez
• Callie Guerra
• Trevor Guerra
• Maria Guevara
• Camilo Guiang, MD
• Stacy Marie Guisse, MS LMFT
• Nick Laddhaphol Gunasayan, D.P.M.
• Madeline Gurewitz, PA-C
• Robert Gurrola, RAS
• Nancyann Pawlik Guthrie, MD

• Psychiatry Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.