Individual
ELLIOT MAGDALENO GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
481 4TH ST, HOLLISTER, CA 95023-3840
(831) 636-4000
Mailing address
481 4TH ST, HOLLISTER, CA 95023-3840
(831) 636-4000
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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