Individual provider Active NPI

Maria Rita Guevara, MD

  • Nuclear Imaging & Therapy Physician
  • North Hollywood, CA
National Provider Identifier
1316124662
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Imaging & Therapy PhysicianTaxonomy code 207UN0902X
License
A102275 Issued in CA
Practice address
12253 Dehougne St
North Hollywood, CA 91605-5611
Phone
(310) 386-4879
NPI assigned
Jan 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Imaging & Therapy Physician 207UN0902X A102275 CA Primary

Addresses

Primary practice location

12253 Dehougne St
North Hollywood, CA 91605-5611

Mailing address

12253 Dehougne St
North Hollywood, CA 91605-5611
Phone (310) 386-4879

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
I20160721001011 CA Practitioner - Family Practice 5395038822 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102275CAMDNuclear Imaging & Therapy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Atlast West la CurrentSince Aug 1, 2016 Accepting new patients
Health Atlast West la CurrentSince Aug 1, 2016 Accepting new patients
Health Atlast West la Inc Current Accepting new patients
Sherman Oaks Integrated Medical Group, Inc. CurrentSince Sep 1, 2016 Accepting new patients

Locations

3030 Sawtelle Blvd
Los Angeles, CA 90066
Phone (310) 390-9018

2428 Santa Monica Blvd
Ste 308
Santa Monica, CA 90404
Phone (310) 453-8389

4835 Van Nuys Blvd
Ste 105
Sherman Oaks, CA 91403
Phone (818) 786-5985

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1316124662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12253 DEHOUGNE ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055611",
            "telephone_number": "310-386-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12253 DEHOUGNE ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055611",
            "telephone_number": "310-386-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "MARIA",
        "middle_name": "RITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "CA",
            "license": "A102275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.