Provider Demographics
NPI:1417948423
Name:GUTIERREZ, MARY A (PHARMD)
Entity Type:Individual
Prefix:PROF
First Name:MARY
Middle Name:A
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PHARMD
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Mailing Address - Street 1:UNIVERSITY OF SOUTHERN CALIFORNIA SCH OF PHARMACY
Mailing Address - Street 2:1985 ZONAL AVE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089
Mailing Address - Country:US
Mailing Address - Phone:323-442-1456
Mailing Address - Fax:323-442-1681
Practice Address - Street 1:UNIVERSITY OF SOUTHERN CALIFORNIA SCH OF PHARMACY
Practice Address - Street 2:1985 ZONAL AVE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0001
Practice Address - Country:US
Practice Address - Phone:323-442-1456
Practice Address - Fax:323-442-1681
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA412581835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric