Healthcare Provider Details

I. General information

NPI: 1255120788
Provider Name (Legal Business Name): ISAVEYLA GUTIERREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 E COMPTON BLVD
COMPTON CA
90220-2410
US

IV. Provider business mailing address

145 W 60TH ST
LOS ANGELES CA
90003-1113
US

V. Phone/Fax

Practice location:
  • Phone: 424-529-6755
  • Fax:
Mailing address:
  • Phone: 779-302-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1255120788
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: