Provider Demographics
NPI:1942388749
Name:GUYER, MARION L (MD)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:L
Last Name:GUYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S. ELISEO
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREEBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94902-1408
Mailing Address - Country:US
Mailing Address - Phone:415-461-5552
Mailing Address - Fax:415-464-8964
Practice Address - Street 1:1300 S. ELISEO
Practice Address - Street 2:SUITE 203
Practice Address - City:GREEBRAE
Practice Address - State:CA
Practice Address - Zip Code:94902-1408
Practice Address - Country:US
Practice Address - Phone:415-461-5552
Practice Address - Fax:415-464-8964
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66859207R00000X
CT052399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1942388749Medicaid
CAA66859OtherSTATE MEDICAL LICENSE
CT1942388749Medicaid