Healthcare Provider Details

I. General information

NPI: 1902718802
Provider Name (Legal Business Name): ERICK GUTIERREZ DMD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 MANHATTAN BEACH BLVD
MANHATTAN BEACH CA
90266-5121
US

IV. Provider business mailing address

1005 MANHATTAN BEACH BLVD
MANHATTAN BEACH CA
90266-5121
US

V. Phone/Fax

Practice location:
  • Phone: 310-546-4675
  • Fax:
Mailing address:
  • Phone: 310-546-4675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ERICK GUTIERREZ
Title or Position: DENTIST / PRESIDENT
Credential: DMD
Phone: 310-546-4575