MEDICARE: RIGOBERTO GUTIERREZ

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	207V00000X	Obstetrics & Gynecology Physician	G76723	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160056751	OTHER		MEDICARE RAILROAD #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124023254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIGOBERTO GUTIERREZ

Provider Business Mailing Address
First Line	:	PO BOX 5010
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95966-0010
Country	:	US
Telephone Number	:	530-538-9410
Fax Number	:	530-538-9411

Provider Business Practice Location Address
First Line	:	2809 OLIVE HWY
Second Line	:	STE 370
City	:	OROVILLE
State	:	CA
Zip	:	95966-6136
Country	:	US
Telephone Number	:	530-538-9410
Fax Number	:	530-538-9411

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	11/15/2010

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Directions to “ RIGOBERTO GUTIERREZ ” Practice Location

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