Individual
JUAN CARLOS GUTIERREZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-7000
(219) 743-1730
Mailing address
13127 14TH ST, BUILDING 13127, CAMP PENDLETON, CA 92058
(760) 763-0306
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/31/2023
Last updated
08/17/2023
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