DR. RAPHAEL FAJARDO GUANZON M.D. NPI 1184732992

NPI Information

NPI: 1184732992
Provider Name: DR. RAPHAEL FAJARDO GUANZON, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
704 LONDON ST # A
PORTSMOUTH, VA
ZIP 23704
Phone: (757) 399-0513
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DR. Raphael Fajardo Guanzon, M.D. is a general practice in Portsmouth, VA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Raphael Fajardo Guanzon, M.D. NPI is 1184732992. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

704 LONDON ST # A
PORTSMOUTH, VA
ZIP 23704-413
Phone: (757) 399-0513

The NPI 1184732992 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 12/31/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		0101026720	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003121	OTHER	VIRGINIA	ANTHEM
2	005671213	MEDICAID	VIRGINIA
3	012936651	MEDICARE PIN	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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