MEDICARE: LORETTA GUTIERREZ CALDERON

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	225100000X	Physical Therapist	PT37868	CA

General Provider Information

NPI Number	:	1982138541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORETTA GUTIERREZ CALDERON

Provider Business Mailing Address
First Line	:	2401 DETROIT AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79930-1014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 DETROIT AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79930-1014
Country	:	US
Telephone Number	:	915-329-3725
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	11/17/2025

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