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General NPI Number Information
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NPI Number | 1639245608
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Entity Type | Individual
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Provider Name | MATTHEW ALAN GUTIERREZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 05/25/2015
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Provider Practice Location Address
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Address Line | 20 ALLEN ST
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City | MARTINEZ
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State | CA
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Zip | 94553-2681
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Country | US
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Telephone | 925-370-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 12533 SPRINGSNOW CIR
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City | CERRITOS
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State | CA
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Zip | 90703-8326
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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 |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A83812
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License Number State | CA
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