Basic Information
| Provider Information | |||||||||
| NPI: | 1760983308 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUTIERREZ | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WINGER | ||||||||
| OtherFirstName: | ALLISON | ||||||||
| OtherMiddleName: | JEAN | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6848 BONNIE VIEW DR | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921192202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579532339 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | U. S. NMRTC YOKOSUKA | ||||||||
| Address2: | PSC 475 #8 | ||||||||
| City: | FPO | ||||||||
| State: | AP | ||||||||
| PostalCode: | 96350 | ||||||||
| CountryCode: | JP | ||||||||
| TelephoneNumber: | 3152438649 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2018 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 0101267463 | VA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.