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General NPI Number Information
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NPI Number | 1295982734
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Entity Type | Organization
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Legal Business Name | GUEY C MARK M D INC
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 1072 W. MONTEREY AVENUE
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City | STOCKTON
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State | CA
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Zip | 95204-3031
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Country | US
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Telephone | 209-463-2180
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Fax |
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Provider Business Mailing Address
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Address Line | 1072 W. MONTEREY AVENUE
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City | STOCKTON
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State | CA
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Zip | 95204-3031
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Country | US
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Telephone | 209-463-2180
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF GUEY C MARK M D INC
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Name | DR. GUEY C MARK
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Credential |
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Telephone | 209-463-2180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | C191890
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License Number State | CA
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