DR. VICTORIA DE GUZMAN FERNANDO (NPI# 1073517686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073517686 |
| Entity Type | Individual |
| Full Name | DR. VICTORIA DE GUZMAN FERNANDO |
| Credential | M.D. |
| Practice Address |
2100 N Martin Luther King Jr Blvd Emergency Medicine Department Clovis NM 88101 |
| Mailing Address |
2100 Martin Luther King Jr Blvd Clovis NM 88101 |
| Practice Telephone | 6017653180 |
| Practice Fax Number | 6017652808 |
| Mailing Telephone | 5757697335 |
| Mailing Fax Number | 5757697336 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2016-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 18178 | MS | Allopathic & Osteopathic Physicians |
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
MD2010-0102 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BF8479506 | 01 | |
| MS | 00737798 | 05 |
| Street Address |
2100 N MARTIN LUTHER KING JR BLVD EMERGENCY MEDICINE DEPARTMENT |
| City | CLOVIS |
| State | NM |
| Zip Code | 88101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548569023 | Rulon B Holman | Nurse Anesthetist, Certified Registered | 2100 N Martin Luther King Jr Blvd, Clovis, NM 88101 | 2011-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748692 | Patrick James Scollon | Military Health Care Provider | 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 | 2020-04-14 |
| 1285274878 | Keishla Cota | Physical Therapist | 100 East Manana Blvd, Unit 1, Clovis, NM 88101 | 2020-01-10 |
| 1659927283 | Ndeye Ndour | Nurse Anesthetist, Certified Registered | 2100 N M.l.k. Jr Blvd, Clovis, NM 88101 | 2019-08-09 |
| 1679132468 | Justine Nicole Nunez | Nurse Practitioner | 2301 North Doctor Martin Luther King Boulevard, Clovis, NM 88101 | 2019-06-06 |
| 1518453521 | Moore Psychological Services, Pllc | Social Worker | 1908 West 21st Street, Clovis, NM 88101 | 2018-07-03 |
| 1912494006 | Raesha Russell | Behavior Technician | 214 West 9th St, Clovis, NM 88101 | 2018-04-16 |
| 1013425800 | Vanessa Yardley | Registered Nurse | 2100 N. Martin Luther King Jr. Blvd., Clovis, NM 88101 | 2018-01-16 |
| 1699204230 | Olivia Garcia | Technician, Other | 1100 W 21st Street, Clovis, NM 88101 | 2017-06-07 |
| 1578006250 | Mary Ellen Gray | Technician, Other | 9408 B Vermont Court, Clovis, NM 88101 | 2016-11-29 |
| 1205296977 | Malaney Harmon | Behavioral Analyst | 2700 E 7th St., Clovis, NM 88101 | 2016-02-24 |
| Find all providers in zip 88101 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508932369 | James Gilbert Osborne Jr. | Emergency Medicine | 2755 Herndon Ave, Clovis, CA 93611-6800 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215230644 | Barbara Lynn Schmeits Hapke | Emergency Medicine | Country Road A-78, Private Road 2001 #18, Raton, NM 87740-0446 | 2010-12-07 |
| 1699807248 | Alfred William Neely | Emergency Medicine | 22 Meadow Hawk Ln, Silver City, NM 88022-9727 | 2007-03-09 |
| 1972682078 | Elin Mckinnon Ritchie | Emergency Medicine | Hc 74 Box 21913, El Prado, NM 87529 | 2006-11-02 |
| 1952366700 | Philip Seidenberg | Emergency Medicine | Unm Department of Emergency Medicine Msc10, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2006-04-17 |
| 1669433017 | William M Roethel | Emergency Medicine | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2006-03-28 |
| 1427039759 | Warner J Anderson | Emergency Medicine | 218 Cousins Road, Vanderwagen, NM 87326 | 2005-11-14 |
| 1003800822 | James D Schmitz | Emergency Medicine | 42 S Florida Ave, Alamogordo, NM 88310-9533 | 2005-09-08 |
| 1245891647 | Abq Ip LLC | Emergency Medicine | 9310 Coors Blvd Nw, Albuquerque, NM 87114-4006 | 2019-06-26 |
| 1376007765 | Abq Ep, LLC | Emergency Medicine | 9310 Coors Blvd Nw, Albuquerque, NM 87114-4006 | 2019-01-30 |
| 1174016455 | Claire Marie Pultz | Emergency Medicine | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2018-06-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.