Anna D Guanche MD Inc – Dermatology Physician

Key facts

NPI: 1902859770
Entity type: Organization (NPI type 2)
Primary specialty: Dermatology Physician 207N00000X
License: A85096 (CA)
Legal business name: ANNA D GUANCHE MD INC
Practice address: 23622 Calabasas Rd
Suite 339
Calabasas, CA 91302-1549
Phone: (818) 225-0117
Fax: (818) 225-0127
NPI assigned: May 19, 2006
Organization subpart: No

Authorized official

Name: Anna D Guanche, MD
Title: President
Phone: (818) 225-0117

Practitioners 2

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

Anna D Guanche, MD Dermatology Physician · Calabasas, CA · NPI 1982658761

Medicare reassignment NPD CA · DERMATOLOGY
Ananda Lyra Fidani, PA-C Medical Physician Assistant · Calabasas, CA · NPI 1497005029

Medicare reassignment CA

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20060914000617	CA	Part B Supplier - Clinic/Group Practice	5890799373	Receives reassigned benefits from 2 practitioners Practice locations: Calabasas, CA

National Provider Directory

Networks

BSC 65 PLUS INDIVIDUAL MAPD
Plans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dermatology Physician Group: 193400000X SINGLE SPECIALTY GROUP	207N00000X	A85096	CA	Yes

Addresses

Primary practice location

23622 Calabasas Rd
Suite 339
Calabasas, CA 91302-1549

Mailing address

23622 Calabasas Rd
Suite 339
Calabasas, CA 91302-1549
Phone (818) 225-0117

Other names

Bella Skin Institute Inc Doing business as

Other providers in Calabasas, CA

All providers in Calabasas, CA · Dermatology Physician in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.