Physician Compare National (NPI:1659389971)

HEALTHCARE PROVIDER: J SANTIAG GUTIERREZ M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659389971
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820991474
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100601000597
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GUTIERREZ
	Individual professional last name
Provider First Name	J SANTIAGO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6930 SPRINGFIELD AVE
	Group Practice or individual's line 1 address
City	LAREDO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	780412312
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9567258484
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450029
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAREDO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450643
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	DOCTORS HOSPITAL OF LAREDO
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y