Organization
JEFFREY J. GUTTAS. MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE NG (BILLING MANAGER)
(650) 696-4101
Entity
Organization
Contact information
Practice address
100 S SAN MATEO DR, STE 400, SAN MATEO, CA 94401-3805
(650) 696-4101
(650) 696-4121
Mailing address
100 S SAN MATEO DR, STE 400, SAN MATEO, CA 94401-3805
(650) 696-4101
(650) 696-4121
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
G612560
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G612560
—
CA
05
—
00G612561
—
CA
01
—
0716704
AETNA
CA
01
—
0718408
AETNA
CA
01
—
0732307
AETNA
CA
01
—
ZZZ52816Z
BS
—
Enumeration date
06/08/2005
Last updated
08/22/2020
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