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NPI Code Detail

MEDICARE: ELIJAH C GUTMAN

MEDICARE: ELIJAH C GUTMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorCI5662NV

General Provider Information

NPI Number : 1811854318
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIJAH C GUTMAN
Provider Business Mailing Address
First Line : 6348 BRANDYWINE WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-3432
Country : US
Telephone Number : 702-502-2004
Fax Number :
Provider Business Practice Location Address
First Line : 5426 VEGAS DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-2403
Country : US
Telephone Number : 702-502-2004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2026
Last Update Date : 01/06/2026

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Directions to “ ELIJAH C GUTMAN ” Practice Location

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