Active NPI
Guido D Abellera MD a Professional Medical Corporation
- Medical Specialty Clinic/Center
- Stockton, CA
National Provider Identifier
1720368764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- License
- A338570
- Legal business name
- GUIDO D ABELLERA MD A PROFESSIONAL MEDICAL CORPORATION
- Practice address
- 123 S Commerce St
Suite D
Stockton, CA 95202-2837 - Phone
- (209) 467-6825
- Fax
- (209) 467-6827
- NPI assigned
- Aug 23, 2011
- Last updated
- Nov 4, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Guido Dulay Abellera, M.D.
- Title
- President
- Phone
- (209) 467-6825
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | A338570 | CA | Primary |
Addresses
Primary practice location
123 S Commerce St
Suite D
Stockton, CA 95202-2837
Mailing address
123 S Commerce St
Suite D
Stockton, CA 95202-2837
Phone (209) 467-6825
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A338570 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
123 S Commerce St
Ste D
Stockton, CA 95202
Phone (209) 466-5462
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Stockton, CA
- NPI 1477562486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314057600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320364800000",
"number": "1720368764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 S COMMERCE ST",
"address_2": "SUITE D",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952022837",
"telephone_number": "209-467-6825",
"fax_number": "209-467-6827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 S COMMERCE ST",
"address_2": "SUITE D",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952022837",
"telephone_number": "209-467-6825",
"fax_number": "209-467-6827"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GUIDO D ABELLERA MD A PROFESSIONAL MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2011-08-23",
"last_updated": "2011-11-04",
"status": "A",
"authorized_official_last_name": "ABELLERA",
"authorized_official_first_name": "GUIDO",
"authorized_official_middle_name": "DULAY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "209-467-6825",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "CA",
"license": "A338570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A338570",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.