Individual provider Active NPI

Nikolas Brien Gutierrez, DO

  • Family Medicine Physician
  • Camp Pendleton, CA
National Provider Identifier
1629636477
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102206338 Issued in VA
Practice address
200 Mercy Circle
Camp Pendleton, CA 92055
Phone
(760) 719-3675
NPI assigned
Jun 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102206338 VA Primary

Addresses

Primary practice location

200 Mercy Circle
Camp Pendleton, CA 92055

Mailing address

200 Mercy Circle
Camp Pendleton, CA 92055
Phone (760) 725-1400

Other practice location 1

200 Mercy Cir
Oceanside, CA 92055
Phone (760) 725-4357

Other practice location 2

200 Mercy Cir
Camp Pendleton, CA 92055
Phone (760) 719-3675

Other identifiers 1

IdentifierTypeStateIssuer
VAD0000OtherUS NAVY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL pobox5555534,camppendleton,ca,92057 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114000412 VA Order and Referring Only - Family PracticePractitioner - Family Practice 3173051588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206338VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NH Camp Pendleton Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1629636477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-719-3675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mercy Cir",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "92055",
            "country_code": "US",
            "telephone_number": "760-725-4357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Mercy Cir",
            "address_purpose": "LOCATION",
            "city": "Camp Pendleton",
            "state": "CA",
            "postal_code": "92055",
            "country_code": "US",
            "telephone_number": "760-719-3675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "NIKOLAS",
        "middle_name": "BRIEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102206338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US NAVY",
            "identifier": "VAD0000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pobox5555534,camppendleton,ca,92057",
            "affiliation": "N",
            "endpointDescription": "Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "200 Mercy Cir",
            "city": "Camp Pendleton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

Verify at the official NPI Registry.