NPIMap

Organization Active NPI

Ismael Guerrero MD PLLC

  • Family Medicine Physician
  • Yuma, AZ
National Provider Identifier
1407929920
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21545 Issued in AZ
Legal business name
ISMAEL GUERRERO MD PLLC
Practice address
1965 West 24TH Street
Ste a
Yuma, AZ 85364
Phone
(928) 344-5951
Fax
(928) 344-5779
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Authorized official

Name
Ismael Inclan Guerrero, MD
Title
Owner
Phone
(928) 344-5951

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 21545 AZ Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 2891 AZ
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 1458 AZ
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 2125 AZ

Addresses

Primary practice location

1965 West 24TH Street
Ste a
Yuma, AZ 85364

Mailing address

1965 West 24TH Street
Ste a
Yuma, AZ 85364
Phone (928) 344-5951

Other identifiers 2

IdentifierTypeStateIssuer
139841MedicaidAZ
502098MedicaidAZ

National Provider Directory

National Provider Directory

Locations

1150 W 24th St
Ste F
Yuma, AZ 85364
Phone (928) 782-3819

Practitioners & affiliated clinicians

Practitioners 2

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": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1407929920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 WEST 24TH STREET",
            "address_2": "STE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-344-5951",
            "fax_number": "928-344-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 WEST 24TH STREET",
            "address_2": "STE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-344-5951",
            "fax_number": "928-344-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISMAEL GUERRERO MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "GUERRERO",
        "authorized_official_first_name": "ISMAEL",
        "authorized_official_middle_name": "INCLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-344-5951",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "21545",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2891",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1458",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2125",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139841",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502098",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.