Loida V. Guevarra, M.D., Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A53408 Issued in CA

Legal business name

LOIDA V. GUEVARRA, M.D., INC.

Practice address

12760 Hesperia Rd
Suite a
Victorville, CA 92395-5806

Phone

(760) 955-1166

Fax

(760) 955-1499

NPI assigned

Dec 29, 2005

Last updated

Jul 14, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Loida V Guevarra, M.D.NPI 1346329331

Title

President

Phone

(760) 955-1166

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEBDAA

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Loida Vitan Guevarra, M.D.

  • Family Medicine Physician
  • Victorville, CA
  • NPI 1346329331
  Medicare reassignment NPD Authorized official
• Joanne Marie Lister, FNP C

  • Family Nurse Practitioner
  • Upland, CA
  • NPI 1467407767
  Medicare reassignment NPD

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1932186913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 HESPERIA RD",
            "address_2": "SUITE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955806",
            "telephone_number": "760-955-1166",
            "fax_number": "760-955-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12760 HESPERIA RD",
            "address_2": "SUITE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955806",
            "telephone_number": "760-955-1166",
            "fax_number": "760-955-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOIDA V. GUEVARRA, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "GUEVARRA",
        "authorized_official_first_name": "LOIDA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-955-1166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A53408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "805219",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A534080",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "046950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "A53408",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "01991-0023",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IVHP",
            "identifier": "05256000004",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Locken, O.D.
• Naomi Loera
• Britney Nicole Logan, LVN
• Shawntel Logan, NP
• David Loh
• Loma Linda Vamc
• Maby Lomotos
• Breana Long
• Joshua Bentley Taeb Long
• Wesley Long, CSACI, CSACII

• Primary Care Clinic/Center in Victorville, CA
• Providers in Victorville, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare 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.