Individual provider Active NPI

Kathleen Gutierrez, M.D.

  • Pediatric Infectious Diseases Physician
  • Stanford, CA
National Provider Identifier
1053455261
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
G69973 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-5682
Fax
(650) 725-8040
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X G69973 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303-3341
Phone (650) 497-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G69973CAMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1053455261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EMBARCADERO RD",
            "address_2": "STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033341",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-5682",
            "fax_number": "650-725-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CA",
            "license": "G69973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.