Individual
MR. LUIS CARLOS GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
700 W CAMPBELL AVE STE 15, PHOENIX, AZ 85013-2691
(623) 600-4126
(628) 412-7317
Mailing address
700 W CAMPBELL AVE STE 15, PHOENIX, AZ 85013-2691
(623) 600-4126
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6258
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075466
—
AZ
Enumeration date
10/14/2015
Last updated
11/02/2023
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