Fernando Gutierrez
Individual provider Active NPI Athletic Trainer · Tranquillity, CA
NPI 1578014023 · NPPES record last updated Oct 19, 2016
Key facts
- NPI
- 1578014023
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- IA20831 (IA)
- Practice address
- 7341 S James Rd
Tranquillity, CA 93668-9720 - Phone
- (559) 408-1339
- NPI assigned
- Oct 19, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IA20831 | IA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | IA20831 | IA | Yes |
Addresses
Primary practice location
7341 S James Rd
Tranquillity, CA 93668-9720
Mailing address
7341 S James Rd
Tranquillity, CA 93668-9720
Phone (559) 408-1339
Other providers in Tranquillity, CA
All providers in Tranquillity, CA · Athletic Trainer in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.