Provider Demographics
NPI:1386724805
Name:ABELLERA, GUIDO DULAY (MD)
Entity type:Individual
Prefix:DR
First Name:GUIDO
Middle Name:DULAY
Last Name:ABELLERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:123 S COMMERCE ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202
Mailing Address - Country:US
Mailing Address - Phone:209-467-6826
Mailing Address - Fax:209-467-6827
Practice Address - Street 1:123 S COMMERCE ST STE D
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2837
Practice Address - Country:US
Practice Address - Phone:209-467-6826
Practice Address - Fax:209-467-6827
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA338570207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A338570Medicaid
CA00A338570Medicaid
A27274Medicare UPIN