Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 20A9941 | CA |
NPI | 1033245816 |
---|---|
Provider Name | Dr. Jason M. Guardino |
First Address | Sacramento, CA 95823-4671 |
Second Address | Sacramento, CA 95823-4671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 14/12/2021 |