Individual provider Active NPI

Hector Antonio Gutierrez, FNP-C

  • Family Nurse Practitioner
  • Pomona, CA
National Provider Identifier
1184357303
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021544 Issued in CA
Practice address
210 W Bonita Ave Ste 100
Pomona, CA 91767-1866
Phone
(909) 623-3428
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95021544 CA Primary

Addresses

Primary practice location

210 W Bonita Ave Ste 100
Pomona, CA 91767-1866

Mailing address

210 W Bonita Ave Ste 100
Pomona, CA 91767-1866
Phone (909) 623-3428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240415003348 CA Practitioner - Nurse Practitioner 5496194151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inland Urology Medical Group IncGroup PAC ID 3173568839, 8 clinicians

Practice addresses (Care Compare)

210 W Bonita Ave
Suite 100
Pomona, CA 91767-1865
Phone (909) 623-3428

Hospital & facility affiliations

  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Urology Medical Group Inc CurrentSince Feb 13, 2024 Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

2140 Grand Ave
Ste 120
Chino Hills, CA 91709
Phone (909) 392-2002

160 E Artesia St
Ste 220
Pomona, CA 91767
Phone (909) 623-3428

210 W Bonita Ave
Ste 100
Pomona, CA 91767
Phone (909) 623-3428

1113 Alta Ave
Ste 110
Upland, CA 91786
Phone (909) 949-8000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1184357303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W BONITA AVE STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671866",
            "telephone_number": "909-623-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W BONITA AVE STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671866",
            "telephone_number": "909-623-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "HECTOR",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.