Provider Demographics
NPI:1548345770
Name:GUILFORD, FREDERICK TIMOTHY
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:TIMOTHY
Last Name:GUILFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 EL CAMINO REAL
Mailing Address - Street 2:#110
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022
Mailing Address - Country:US
Mailing Address - Phone:650-964-6700
Mailing Address - Fax:650-964-3495
Practice Address - Street 1:5050 EL CAMINO REAL
Practice Address - Street 2:#110
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022
Practice Address - Country:US
Practice Address - Phone:650-964-6700
Practice Address - Fax:650-964-3495
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC38149207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A36855Medicare UPIN
00C381490Medicare ID - Type Unspecified