Provider Demographics
NPI:1801906995
Name:GUETZKOW, JAMES STEERE (MD, CDE)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEERE
Last Name:GUETZKOW
Suffix:
Gender:M
Credentials:MD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 KOCHER DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5516
Mailing Address - Country:US
Mailing Address - Phone:408-398-4831
Mailing Address - Fax:408-613-2021
Practice Address - Street 1:1852 KOCHER DRIVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5516
Practice Address - Country:US
Practice Address - Phone:408-398-4831
Practice Address - Fax:408-613-2021
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35753207Q00000X, 207R00000X, 208M00000X
ORMD166811208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG35753OtherCALIFORNIA MEDICAL CERTIF
CAG35753OtherCALIFORNIA MEDICAL CERTIF