Provider Demographics
NPI:1255120788
Name:GUTIERREZ, ISAVEYLA (MD)
Entity type:Individual
Prefix:
First Name:ISAVEYLA
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 W 60TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-1113
Mailing Address - Country:US
Mailing Address - Phone:779-302-5010
Mailing Address - Fax:
Practice Address - Street 1:145 W 60TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1113
Practice Address - Country:US
Practice Address - Phone:779-302-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program