Distefano, James Guido

Distefano, James Guido is an sole proprietor health care provider with primary practice located at 947 Marina Village Pkwy , Alameda CA 94501-1048. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Distefano, James Guido can be contacted via phone (510) 522-6637.

Contact Information

Primary practice address
947 Marina Village Pkwy Alameda CA 94501-1048
Phone: (510) 522-6637
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X A103423 California

Profile Details

NPI number 1942513882
LBN Legal business name Distefano, James Guido
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 21st, 2010
Last updated Aug 28th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942513882 NPPES
California MEDICAID 1427081165

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