Provider Demographics
NPI:1578613907
Name:DIANA F GUTHANER M D INC
Entity Type:Organization
Organization Name:DIANA F GUTHANER M D INC
Other - Org Name:NORTHERN CALIFORNIA WOMENS IMAGING CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTHANER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-617-8655
Mailing Address - Street 1:2421 PARK BLVD STE B202
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1956
Mailing Address - Country:US
Mailing Address - Phone:650-617-8655
Mailing Address - Fax:650-322-3416
Practice Address - Street 1:2421 PARK BLVD STE B202
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1956
Practice Address - Country:US
Practice Address - Phone:650-617-8655
Practice Address - Fax:650-322-3416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30203261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300007822OtherMEDICARE RAILROAD
CAZZZ02167ZMedicare PIN
CA300007822OtherMEDICARE RAILROAD