Provider Demographics
NPI:1891866869
Name:JEFFREY J. GUTTAS, M.D. A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JEFFREY J. GUTTAS, M.D. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUTTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-696-4100
Mailing Address - Street 1:100 S SAN MATEO DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3805
Mailing Address - Country:US
Mailing Address - Phone:650-696-4100
Mailing Address - Fax:650-696-4121
Practice Address - Street 1:100 S SAN MATEO DR
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3805
Practice Address - Country:US
Practice Address - Phone:650-696-4100
Practice Address - Fax:650-696-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty