Provider Demographics
NPI:1881682656
Name:LIVNAT, GUY SHIR (MD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:SHIR
Last Name:LIVNAT
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 1:100A DRAKE'S LANDING ROAD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904
Mailing Address - Country:US
Mailing Address - Phone:415-924-1214
Mailing Address - Fax:415-924-1375
Practice Address - Street 1:100A DRAKE'S LANDING ROAD
Practice Address - Street 2:SUITE 225
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904
Practice Address - Country:US
Practice Address - Phone:415-924-1214
Practice Address - Fax:415-924-1375
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG96438207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A804550Medicaid
CA00A804550Medicaid