Healthcare Provider Details

I. General information

NPI: 1689108359
Provider Name (Legal Business Name): PAULA M GUTIERREZ CANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST 2ND FLR A2
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

1411 E 31ST ST 2ND FLR A2
OAKLAND CA
94602-1018
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-5039
  • Fax: 510-535-7313
Mailing address:
  • Phone: 510-437-5039
  • Fax: 510-535-7313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA162674
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA162674
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA162674
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA162674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: