Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | A23865 | CA |
NPI | 1770673501 |
---|---|
Provider Name | Dr. J Anthony Guichard |
First Address | San Francisco, CA 94128-1560 |
Second Address | Redwood City, CA 94062-2751 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A238652 | (05) | CA |
A23732 | (02) | CA |
A23865 | MEDICAL LICENSE (01) | CA |