Provider Demographics
NPI:1982876884
Name:GUTIERREZ, RUDOLPH ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:ANDREW
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1270 SPRINGBROOK RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3971
Mailing Address - Country:US
Mailing Address - Phone:925-938-9303
Mailing Address - Fax:925-938-9304
Practice Address - Street 1:1270 SPRINGBROOK RD
Practice Address - Street 2:SUITE A
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3971
Practice Address - Country:US
Practice Address - Phone:925-938-9303
Practice Address - Fax:925-938-9304
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACQ363ZMedicare UPIN