Individual provider Active NPI

Bradley K Guion, PA-C

  • Physician Assistant
  • National City, CA
National Provider Identifier
1578195707
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58536 Issued in CA
Practice address
502 Euclid Ave Ste 204
National City, CA 91950-2949
Phone
(619) 765-2684
NPI assigned
Feb 5, 2020
Last updated
Feb 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 58536 CA Primary

Addresses

Primary practice location

502 Euclid Ave Ste 204
National City, CA 91950-2949

Mailing address

502 Euclid Ave Ste 204
National City, CA 91950-2949

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220525003053 CA Practitioner - Physician Assistant 6103225404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kab Medical Group IncGroup PAC ID 7719211358, 15 clinicians

Practice addresses (Care Compare)

765 3Rd Ave
Suite 100
Chula Vista, CA 91910-5842
Phone (858) 925-6137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58536CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurowell Medical Group Current Accepting new patients
Oasis Wellness Group, Inc. Past Accepting new patients

Locations

1820 W Orangewood Ave
Ste 105
Orange, CA 92868
Phone (562) 230-5899

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1578195707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 204",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 204",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502949",
            "telephone_number": "619-765-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUION",
        "first_name": "BRADLEY",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-05",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.