Mark Gutierrez, DC | |
13732 Newport Ave Ste 1, Tustin, CA 92780-4698 | |
(714) 406-0242 | |
Not Available |
Full Name | Mark Gutierrez |
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Gender | Male |
Speciality | Chiropractor |
Location | 13732 Newport Ave Ste 1, Tustin, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114357969 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | DC32691 (California) | Primary |
Provider Name | Gutierrez Chiropractic Management Incorporated |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1457100281 PECOS PAC ID: 0143756759 Enrollment ID: O20241205003992 |
Mailing Address | Practice Location Address |
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Mark Gutierrez, DC 13732 Newport Ave Ste 1, Tustin, CA 92780-4698 Ph: (714) 406-0242 | Mark Gutierrez, DC 13732 Newport Ave Ste 1, Tustin, CA 92780-4698 Ph: (714) 406-0242 |
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