Individual
LINDA TELLO GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2210 E ILLINOIS AVE, SUITE 201, FRESNO, CA 93701-2125
(559) 266-2496
(559) 266-8560
Mailing address
3812 N 1ST ST, FRESNO, CA 93726-4301
(559) 495-3120
(559) 495-3134
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
14789
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 14789
PA LICENSE
CA
Enumeration date
12/30/2005
Last updated
03/22/2013
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