Provider Demographics
NPI:1104993500
Name:GUILLEN, RAMIRO (MD)
Entity type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:GUILLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11333 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5185
Mailing Address - Country:US
Mailing Address - Phone:480-367-1500
Mailing Address - Fax:480-367-1501
Practice Address - Street 1:11333 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 280
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5185
Practice Address - Country:US
Practice Address - Phone:480-367-1500
Practice Address - Fax:480-367-1501
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ316532084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ816142Medicaid
AZH09534Medicare UPIN