Juan Carlos Gutierrez, D.C.
Individual provider Active NPI Chiropractor · Sanger, CA
NPI 1790031979 · NPPES record last updated Oct 18, 2016
Key facts
- NPI
- 1790031979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 32058 (CA)
- Practice address
- 609 O St
Sanger, CA 93657-2416 - Phone
- (559) 907-1170
- NPI assigned
- Jul 25, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130215000400 | CA | Practitioner - Chiropractic | 1456505684 |
Reassigns benefits to 1 organization Practice locations: Sanger, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Family Health | Current |
Accepting new patients | |
| Omni Family Health | Current |
Accepting new patients | |
| Omni Family Health | Current | Accepting new patients | |
| Fresno Community Hospital and Medical Center | Past | Accepting new patients | |
| Saint Agnes Medical Center | Past | Accepting new patients | |
| Omni Family Health | Past | Accepting new patients | |
| Valley Children'S Hospital | Past | Accepting new patients |
Locations
4600 Panama Ln
Unit 102B
Bakersfield, CA 93313
Phone (661) 630-7732
277 E Front St
Buttonwillow, CA 93206
Phone (661) 630-7381
2505 Merced St
Fresno, CA 93721
Phone (559) 369-4625
1530 E Manning Ave
Reedley, CA 93654
Phone (559) 558-9741
Interoperability endpoints
- juan.gutierrez.p1@direct.omnifamilyhealth.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 32058 | CA | Yes |
Addresses
Primary practice location
609 O St
Sanger, CA 93657-2416
Mailing address
609 O St
Sanger, CA 93657-2416
Phone (559) 875-4569
Other providers in Sanger, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.