Organization Active NPI

Larry Guerin MD

  • Dermatology Physician
  • Portland, OR
National Provider Identifier
1376609875
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
LARRY GUERIN MD
Practice address
545 NE 47TH Ave
Suite 306
Portland, OR 97213-2238
Phone
(909) 335-8638
Fax
(909) 335-8644
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Larry Guerin, MDNPI 1316961287
Title
Owner
Phone
(909) 335-8638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

545 NE 47TH Ave
Suite 306
Portland, OR 97213-2238

Mailing address

Unit 48
PO Box 5000
Portland, OR 97208-5000

National Provider Directory

National Provider Directory

Locations

545 NE 47th Ave
Ste 306
Portland, OR 97213
Phone (503) 230-0390

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1376609875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIT 48",
            "address_2": "PO BOX 5000",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972085000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 NE 47TH AVE",
            "address_2": "SUITE 306",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132238",
            "telephone_number": "909-335-8638",
            "fax_number": "909-335-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY GUERIN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "GUERIN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-335-8638",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.