Individual
GAWTHAM GUTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1081 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3130
(760) 446-3551
Mailing address
1081 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3130
(760) 446-3551
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
036111915
IL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
C179725
CA
Other
Enumeration date
07/07/2006
Last updated
08/12/2022
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