# MR. ILYAS GUTALE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1497993802
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | PA1776 | NV | — |
| 363A00000X | Physician Assistant | 54636 | CA | — |
| 363A00000X | Physician Assistant | MA053832 | PA | — |
| 363A00000X | Physician Assistant | PA1776 | NV | Yes |
| 363AM0700X | Medical Physician Assistant | PA 9105989 | FL | — |

## Other

- **Enumeration date:** 01/23/2009
- **Last updated:** 04/25/2025