Provider Demographics
NPI:1275653024
Name:GUTTLER, RICHARD BRUCE (MD FACE)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRUCE
Last Name:GUTTLER
Suffix:
Gender:M
Credentials:MD FACE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 16TH STREET
Mailing Address - Street 2:# 2
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-393-8860
Mailing Address - Fax:310-395-8147
Practice Address - Street 1:1328 16TH STREET
Practice Address - Street 2:# 2
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-393-8860
Practice Address - Fax:310-395-8147
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG15677207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism