Provider Demographics
NPI:1689108359
Name:GUTIERREZ CANO, PAULA M
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:GUTIERREZ CANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 E 31ST ST
Mailing Address - Street 2:2ND FLR A2
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1018
Mailing Address - Country:US
Mailing Address - Phone:510-437-5039
Mailing Address - Fax:510-535-7313
Practice Address - Street 1:1411 E 31ST ST
Practice Address - Street 2:2ND FLR A2
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1018
Practice Address - Country:US
Practice Address - Phone:510-437-5039
Practice Address - Fax:510-535-7313
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA162674208M00000X, 207RP1001X, 207RC0200X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care