Provider Demographics
NPI:1215086822
Name:GUO, AHGEE YEAYI (OPTMETRIST)
Entity type:Individual
Prefix:MRS
First Name:AHGEE
Middle Name:YEAYI
Last Name:GUO
Suffix:
Gender:F
Credentials:OPTMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 BANBURY DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-2645
Mailing Address - Country:US
Mailing Address - Phone:415-337-7452
Mailing Address - Fax:510-357-6330
Practice Address - Street 1:420 ESTUDILLO AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4908
Practice Address - Country:US
Practice Address - Phone:510-614-1515
Practice Address - Fax:510-357-6330
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11883T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU92284Medicare UPIN
CAGSD004620Medicare ID - Type Unspecified