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NPI Code Detail

MEDICARE: DR. GUIDO J GORES JR. MD

MEDICARE: DR. GUIDO J GORES JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianG612540CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2LAB93636FOTHERCAMEDICAL CLIA

General Provider Information

NPI Number : 1528073996
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GUIDO J GORES JR. MD
Provider Business Mailing Address
First Line : 909 HYDE ST STE 125
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-4832
Country : US
Telephone Number : 415-771-4366
Fax Number : 415-771-6412
Provider Business Practice Location Address
First Line : 909 HYDE ST STE 125
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-4832
Country : US
Telephone Number : 415-771-4366
Fax Number : 415-771-6412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 01/14/2008

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