Organization Active NPI

Erasto Gutierrez MD Inc

  • Urgent Care Clinic/Center
  • Pomona, CA
National Provider Identifier
1790324481
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ERASTO GUTIERREZ MD INC
Practice address
1749 N Garey Ave
Pomona, CA 91767-2913
Phone
(909) 729-5079
Fax
(909) 729-5081
NPI assigned
Dec 30, 2019
Organization subpart
Yes
Parent organization
ERASTO GUTIERREZ MD INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Archie Trinidad
Title
Manager
Phone
(909) 729-5079

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1749 N Garey Ave
Pomona, CA 91767-2913

Mailing address

1749 N Garey Ave
Pomona, CA 91767-2913
Phone (909) 729-5079

Other names 1

  • POMONA URGENT CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219003062 CA Part B Supplier - Clinic/Group Practice 1355778937 Receives reassigned benefits from 1 practitioner
Practice locations: Pomona, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2180704Pomona Urgent Care1749 N Garey Ave, Pomona, CA 91767Certificate of waiverSep 6, 2026

National Provider Directory

National Provider Directory
Tax ID family
Erasto Gutierrez MD Inc3 organizations share this tax ID, including this one
Part of
Erasto Gutierrez MD Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1749 N Garey Ave
Ste 101
Pomona, CA 91767

1749 N Garey Ave
Pomona, CA 91767
Phone (909) 622-9988

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1790324481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672913",
            "telephone_number": "909-729-5079",
            "fax_number": "909-729-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672913",
            "telephone_number": "909-729-5079",
            "fax_number": "909-729-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERASTO GUTIERREZ MD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERASTO GUTIERREZ MD INC",
        "enumeration_date": "2019-12-30",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "TRINIDAD",
        "authorized_official_first_name": "ARCHIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "909-729-5079"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POMONA URGENT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.