Organization Active NPI

Gutierrez a Medical Corp

  • Family Medicine Physician
  • Murrieta, CA
National Provider Identifier
1093606790
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GUTIERREZ A MEDICAL CORP
Practice address
25924 Jackson Ave
Murrieta, CA 92563-6447
Phone
(626) 664-2073
NPI assigned
Jul 10, 2025
Last updated
Jul 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rolando GutierrezNPI 1104841212
Title
Ceo
Phone
(626) 664-2073

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

25924 Jackson Ave
Murrieta, CA 92563-6447

Mailing address

23811 Washington Ave # C110-272
Murrieta, CA 92562-2275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250819003735 CA Part B Supplier - Clinic/Group Practice 4981103595 Receives reassigned benefits from 1 practitioner
Practice locations: Murrieta, CA

National Provider Directory

National Provider Directory

Locations

23811 Washington Ave
#C110272
Murrieta, CA 92562

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1093606790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23811 WASHINGTON AVE # C110-272",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925622275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25924 JACKSON AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925636447",
            "telephone_number": "626-664-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTIERREZ A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "ROLANDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-664-2073"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.