Provider Demographics
NPI:1538873195
Name:GUO, WILLIAM HENRY (PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:HENRY
Last Name:GUO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28851 OLYMPIA WAY
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-3193
Mailing Address - Country:US
Mailing Address - Phone:909-348-4322
Mailing Address - Fax:
Practice Address - Street 1:2900 STATE ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8458
Practice Address - Country:US
Practice Address - Phone:541-779-1672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA62102363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical