# GUIDO D ABELLERA MD A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720368764
- **Authorized official:** DR. GUIDO DULAY ABELLERA M.D. (PRESIDENT)
- **Authorized official phone:** (209) 467-6825

## Contact information

- **Practice address:** 123 S COMMERCE ST, SUITE D, STOCKTON, CA 95202-2837
- **Practice address phone:** (209) 467-6825
- **Practice address fax:** (209) 467-6827
- **Mailing address:** 123 S COMMERCE ST, SUITE D, STOCKTON, CA 95202-2837
- **Mailing address phone:** (209) 467-6825
- **Mailing address fax:** (209) 467-6827

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A338570 | CA | Yes |

## Other

- **Enumeration date:** 08/23/2011
- **Last updated:** 11/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A338570 | — | CA |