Provider Demographics
NPI:1760983308
Name:GUTIERREZ, ALLISON JEAN (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JEAN
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:JEAN
Other - Last Name:WINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6848 BONNIE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2202
Mailing Address - Country:US
Mailing Address - Phone:757-953-2339
Mailing Address - Fax:
Practice Address - Street 1:U. S. NMRTC YOKOSUKA
Practice Address - Street 2:PSC 475 #1
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96350
Practice Address - Country:JP
Practice Address - Phone:315-243-8649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101267463207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology