Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 00A685450 | CA |
Y | 2086S0102X | Surgical Critical Care | A68545 | CA |
N | 2086S0127X | Trauma Surgeon | 00A685450 | CA |
N | 2086S0127X | Trauma Surgeon | A68545 | CA |
NPI | 1013991769 |
---|---|
Provider Name | Dr. Garth Utter |
First Address | Sacramento, CA 95817-2201 |
Second Address | Sacramento, CA 95817-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 04/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A685450 | (05) | CA |
H26990 | (02) | CA |