Guanco Clinic PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301031105 Issued in MI

Legal business name

GUANCO CLINIC PC

Practice address

47100 Schoenherr Rd
Suite B
Shelby Township, MI 48315-4716

Phone

(586) 566-6880

Fax

(586) 566-6882

NPI assigned

Nov 27, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kirk Guanco

Title

Office Manager

Phone

(586) 566-6880

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1548442072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47100 SCHOENHERR RD",
            "address_2": "SUITE B",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154716",
            "telephone_number": "586-566-6880",
            "fax_number": "586-566-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47100 SCHOENHERR RD",
            "address_2": "SUITE B",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154716",
            "telephone_number": "586-566-6880",
            "fax_number": "586-566-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUANCO CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "GUANCO",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-566-6880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301031105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2107150",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Danna Haba, OD, FCOVD

• Psychiatry Physician in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.