Provider Demographics
NPI:1588255491
Name:SIMPLEVAS PC
Entity type:Organization
Organization Name:SIMPLEVAS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESGAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUARIN-NIETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-603-2140
Mailing Address - Street 1:5191 MAPLE DR STE L
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-8455
Mailing Address - Country:US
Mailing Address - Phone:515-603-1591
Mailing Address - Fax:515-206-6286
Practice Address - Street 1:5191 MAPLE DR STE L
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:IA
Practice Address - Zip Code:50327-8455
Practice Address - Country:US
Practice Address - Phone:515-518-7438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty