Provider Demographics
NPI:1972565307
Name:EGUIA, JOSE MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MARIA
Last Name:EGUIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SHRADER ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1044
Mailing Address - Country:US
Mailing Address - Phone:415-831-6441
Mailing Address - Fax:
Practice Address - Street 1:1 SHRADER ST
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1044
Practice Address - Country:US
Practice Address - Phone:415-831-6441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75495207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A754950Medicare ID - Type Unspecified
H86962Medicare UPIN