Trevor Ray Guevara, Surface IDC
Military Health Care Provider in San Diego, CA. Individual provider (NPI-1).
NPI number1750879151
StatusActive
Last updated in NPPESMay 1, 2018
Details
- NPI
- 1750879151
- Entity type
- Individual (NPI-1)
- Name
- Trevor Ray Guevara
- Credential
- Surface IDC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 1, 2018
- Last updated
- May 1, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171000000X | Military Health Care Provider | – | – | Yes |
Practice location
34101 Farenholt Ave Bldg 14San Diego, CA 92134-7000
Phone 910-548-3919
Mailing address
34101 Farenholt Ave Bldg 14San Diego, CA 92134-5291
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