Provider Demographics
NPI:1033446125
Name:GUY DELOREFICE M.D. INC.
Entity Type:Organization
Organization Name:GUY DELOREFICE M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELOREFICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-938-1255
Mailing Address - Street 1:370 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6827
Mailing Address - Country:US
Mailing Address - Phone:707-938-1255
Mailing Address - Fax:707-938-2321
Practice Address - Street 1:370 PERKINS ST
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6827
Practice Address - Country:US
Practice Address - Phone:707-938-1255
Practice Address - Fax:707-938-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0689180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A689180Medicare PIN
CAG97034Medicare UPIN