Provider Demographics
NPI:1013991769
Name:UTTER, GARTH (MD)
Entity type:Individual
Prefix:DR
First Name:GARTH
Middle Name:
Last Name:UTTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2315 STOCKTON BLVD. - DEPARTMENT OF SURGERY
Mailing Address - Street 2:NAOB 5TH FLOOR - TRAUMA
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:916-734-1768
Mailing Address - Fax:916-734-7821
Practice Address - Street 1:2315 STOCKTON BLVD. - DEPARTMENT OF SURGERY
Practice Address - Street 2:NAOB 5TH FLOOR - TRAUMA
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-1768
Practice Address - Fax:916-734-7821
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A6854502086S0102X, 2086S0127X
CAA685452086S0127X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A685450Medicaid
CAH26990Medicare UPIN