Jack Gutman DO Professional Corp

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

20A4188 Issued in CA

Legal business name

JACK GUTMAN DO PROFESSIONAL CORP

Practice address

6200 E Canyon Rim Rd
Ste 105B
Anaheim, CA 92807-4317

Phone

(714) 998-3627

Fax

(714) 998-1895

NPI assigned

Nov 28, 2010

Organization subpart

No

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

Authorized official

Name

Jack H Gutman, D.O.

Title

Physician/Owner

Phone

(714) 998-3627

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1290902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290902400000",
    "number": "1437451333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 E CANYON RIM RD",
            "address_2": "STE 105B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074317",
            "telephone_number": "714-998-3627",
            "fax_number": "714-998-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 E CANYON RIM RD",
            "address_2": "STE 105B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074317",
            "telephone_number": "714-998-3627",
            "fax_number": "714-998-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK GUTMAN DO PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-28",
        "last_updated": "2010-11-28",
        "status": "A",
        "authorized_official_last_name": "GUTMAN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "714-998-3627",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "20A4188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J.a.L. Santos M.D. Inc
• J&E Supplies & Services LLC
• Jay T. Jablow, MD
• Janice Jabonero
• Veena Theresa Sandejas Jacildo, PTA
• Anthony I Jackson, MSW, LCSW
• Gabrielle C Etchegaray Jackson, DPT
• Jaye Jackson
• Jennifer Joyce Jackson, BA
• Lance Jackson

• Primary Care Clinic/Center in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.