Provider Demographics
NPI:1316911688
Name:GUTIERREZ, ANGEL MAURICIO (DC)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:MAURICIO
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 FRUITRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-4744
Mailing Address - Country:US
Mailing Address - Phone:916-399-9353
Mailing Address - Fax:916-399-1238
Practice Address - Street 1:3330 FRUITRIDGE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-4744
Practice Address - Country:US
Practice Address - Phone:916-399-9353
Practice Address - Fax:916-399-1238
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor