Provider Demographics
NPI:1538903604
Name:GUTIERREZ, DANIEL ELISEO (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ELISEO
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:ELISEO
Other - Last Name:BARRETO-GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 N ALVERNON WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1827
Mailing Address - Country:US
Mailing Address - Phone:520-694-8888
Mailing Address - Fax:
Practice Address - Street 1:707 N ALVERNON WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1827
Practice Address - Country:US
Practice Address - Phone:520-694-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR4423207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine