NPIMap

Individual provider Active NPI

Marc Gutin, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • San Dimas, CA
National Provider Identifier
1861423709
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
G48699 Issued in CA
Practice address
615 E Foothill Blvd Ste C
San Dimas, CA 91773-1255
Phone
(626) 335-8094
Fax
(626) 335-1874
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X G48699 CA Primary

Addresses

Primary practice location

615 E Foothill Blvd Ste C
San Dimas, CA 91773-1255

Mailing address

615 E Foothill Blvd Ste C
San Dimas, CA 91773-1255
Phone (626) 335-8094

Other identifiers 1

IdentifierTypeStateIssuer
00G486990MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060405000675 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 3072522879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Cincinnati College of Medicine and Surgery, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

210 S Grand Ave
Suite 224
Glendora, CA 91741-4273
Phone (626) 335-8094

Hospital & facility affiliations

  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G48699CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marc Gutin M D Inc Endocrinology, Diabetes & Metabolism CurrentSince Oct 1, 1996 Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients

Locations

210 S Grand Ave
Ste 224
Glendora, CA 91741
Phone (626) 335-8094

615 E Foothill Blvd
Ste C
San Dimas, CA 91773
Phone (626) 335-8094

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1861423709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E FOOTHILL BLVD STE C",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731255",
            "telephone_number": "626-335-8094",
            "fax_number": "626-335-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E FOOTHILL BLVD STE C",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731255",
            "telephone_number": "626-335-8094",
            "fax_number": "626-335-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIN",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "G48699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G486990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.