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General NPI Number Information
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NPI Number | 1366475394
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Entity Type | Individual
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Provider Name | NOEL GUTIERREZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 789 W 27TH ST STE 1
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City | YUMA
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State | AZ
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Zip | 85364-7207
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Country | US
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Telephone | 928-344-8400
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Fax | 928-344-8412
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Provider Business Mailing Address
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Address Line | 789 W 27TH ST STE 1
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City | YUMA
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State | AZ
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Zip | 85364-7207
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Country | US
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Telephone | 928-344-8400
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Fax | 928-344-8412
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301073797
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License Number State | MI
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