Provider Demographics
NPI:1124358635
Name:MRGUDICH, ANTHONY PAUL (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PAUL
Last Name:MRGUDICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1569 SLOAT BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1256
Mailing Address - Country:US
Mailing Address - Phone:415-353-9339
Mailing Address - Fax:415-353-3450
Practice Address - Street 1:1569 SLOAT BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1256
Practice Address - Country:US
Practice Address - Phone:415-353-9339
Practice Address - Fax:415-353-3450
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA116037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine