Individual
MR. CASTOR JOSE GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 995-5949
Mailing address
PO BOX 788261, TWENTYNINE PALMS, CA 92278-8261
(619) 995-5949
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/10/2011
Last updated
02/24/2012
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