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Contact Information

C V GUILLERMO JR A PROFESSIONAL MEDICAL CORP
4912 HIGHWAY 1
RACELAND, LA70394
 Phone: 985-532-5092
 Fax: 985-532-8044
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for C V GUILLERMO JR A PROFESSIONAL MEDICAL CORP · (Female)

NPI # 1417085143
Status Active
Credentials
Entity Individual
Enumeration date 03/02/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA License # 03719R
  • LA Medicaid 1124087
  • LA Other 1574214481 BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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