Provider Demographics
NPI:1881564342
Name:HOSPITAL SAN JOSE DE GUAYMAS
Entity type:Organization
Organization Name:HOSPITAL SAN JOSE DE GUAYMAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:EZQUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-896-1181
Mailing Address - Street 1:625 KENMOOR AVE SE STE 301
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MARIA ALBERTO CONTRERAS ZAVALA
Practice Address - Street 2:BLVD MANLIO FABIO BELTRONES 100
Practice Address - City:GUAYMAS
Practice Address - State:SONORA
Practice Address - Zip Code:85500
Practice Address - Country:MX
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access