MEDICARE: DIANA F GUTHANER M D INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0206X	Mammography Clinic/Center	A30203	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300007822	OTHER	CA	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1578613907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANA F GUTHANER M D INC

Provider Business Mailing Address
First Line	:	2421 PARK BLVD STE B202
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-1956
Country	:	US
Telephone Number	:	650-617-8655
Fax Number	:	650-322-3416

Provider Business Practice Location Address
First Line	:	2421 PARK BLVD STE B202
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-1956
Country	:	US
Telephone Number	:	650-617-8655
Fax Number	:	650-322-3416

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DIANA GUTHANER
Credential	:	MD
Telephone Number	:	650-617-8655

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	12/30/2020

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