# CARLOS GUTIERREZ PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** InclusiCare Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811777568
- **Authorized official:** MR. LUIS CARLOS GUTIERREZ PA-C (PRESIDENT/PHYSICIAN ASSISTANT)
- **Authorized official phone:** (623) 873-1200

## Contact information

- **Practice address:** 700 W CAMPBELL AVE STE 15, PHOENIX, AZ 85013-2691
- **Practice address phone:** (623) 349-1392
- **Mailing address:** 700 W CAMPBELL AVE STE 15, PHOENIX, AZ 85013-2691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/02/2023
- **Last updated:** 04/04/2024