Provider Demographics
NPI:1790737724
Name:GUTHANER, DIANA F (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:F
Last Name:GUTHANER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA302032085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300007822OtherMEDICARE RAILROAD
CA00A302031Medicare PIN
A26008Medicare UPIN