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General NPI Number Information
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NPI Number | 1518716679
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Entity Type | Organization
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Legal Business Name | GUTIERREZ MD, PLLC
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Dates
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Enumeration Date | 05/13/2024
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 2920 N GREEN VALLEY PKWY STE 217
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City | HENDERSON
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State | NV
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Zip | 89014-0407
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Country | US
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Telephone | 702-909-8196
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Fax | 702-909-8213
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Provider Business Mailing Address
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Address Line | 130 GENERAL KELLY AVE
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City | HENDERSON
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State | NV
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Zip | 89011-5508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR AND OWNER
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Name | MANUEL F GUTIERREZ JR.
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Credential | MD
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Telephone | 702-909-8196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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