Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A30428 | CA |
Y | 2080A0000X | Adolescent Medicine | A30428 | CA |
NPI | 1255300943 |
---|---|
Provider Name | Dr. Norah Gutrecht |
First Address | Tustin, CA 92780-3429 |
Second Address | Tustin, CA 92780-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 04/01/2011 |