Organization Active NPI

Guido D Abellera MD a Professional Medical Corporation

  • Medical Specialty Clinic/Center
  • Stockton, CA
National Provider Identifier
1720368764
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
A338570 Issued in CA
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, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00A338570MedicaidCA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.