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Individual

TOMASZ D GUTOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1409 E BRIGGSMORE AVE, MODESTO, CA 95355-2707
(209) 550-4788
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A68028
CA
2086S0129X
Vascular Surgery Physician
A68028
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A680280
CA
Enumeration date
05/05/2006
Last updated
06/21/2010
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