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General NPI Number Information
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NPI Number | 1912441643
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Entity Type | Individual
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Provider Name | YESSENIA GUTIERREZ PT
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Gender | Female
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Dates
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Enumeration Date | 12/15/2016
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Last Update Date | 12/15/2016
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Provider Practice Location Address
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Address Line | 6601 RUGBY AVE 401
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4040
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Country | US
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Telephone | 323-589-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 6601 RUGBY AVE 401
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4040
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT291097
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License Number State | CA
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