Provider Demographics
NPI:1740764976
Name:GUTIERREZ, GABRIEL (RRT, RCP)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:RRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S FIGUEROA ST APT 522
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2576
Mailing Address - Country:US
Mailing Address - Phone:949-230-6472
Mailing Address - Fax:
Practice Address - Street 1:9400 ROSECRANS AVE RM B19
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2246
Practice Address - Country:US
Practice Address - Phone:562-461-4665
Practice Address - Fax:562-461-4707
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17046227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered