Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC17974 | CA |
N | 111NN0400X | Neurology | DC17974 | CA |
NPI | 1851302509 |
---|---|
Provider Name | Dr. John Guilford |
First Address | Castro Valley, CA 94546-4317 |
Second Address | Castro Valley, CA 94546-4317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 12/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T88803 | (02) | CA |