NIKOLAS BRIEN GUTIERREZ (NPI# 1629636477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629636477 |
Entity Type | Individual |
Full Name | NIKOLAS BRIEN GUTIERREZ |
Credential | DO |
Practice Address |
200 Mercy Circle Camp Pendleton CA 92055 |
Mailing Address |
Po Box 5555534 Camp Pendleton CA 92057 |
Practice Telephone | 7607193675 |
Mailing Telephone | 7607250025 |
Enumeration Date | 2019-06-05 |
Last Update Date | 2020-09-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | 0102206338 | VA | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
State | Issuer | Identifier | Type Code |
---|---|---|---|
US NAVY | VAD0000 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
200 Mercy Cir, Oceanside, CA 92055 | 7607254357 | |
200 Mercy Cir, Camp Pendleton, CA 92055 | 7607193675 |
Street Address |
200 MERCY CIRCLE |
City | CAMP PENDLETON |
State | CA |
Zip Code | 92055 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649255415 | Wayne Thomas Murphy | Preventive Medicine | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2005-12-14 |
1679172621 | James Darko Ofori | Military Health Care Provider | 200 Mercy Circle, Pharmacy Department, Camp Pendleton, CA 92055 | 2020-10-21 |
1194354662 | Melissa Bruebaker | Military Health Care Provider | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-04-06 |
1891322269 | Pierce Derico | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-03-25 |
1871120774 | Rebeca Arias | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055 | 2020-03-23 |
1871128710 | Angela Christine Lacey | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2020-03-11 |
1447800727 | David Singleton | Dentist | 200 Mercy Circle, Camp Pendleton, CA 92055-6527 | 2019-09-18 |
1689233470 | Bryce Allen Bowers | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055 | 2019-06-06 |
1518525369 | Elizabeth Helen Shields | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | 2019-06-05 |
1902464845 | Hilary Carol Hopkins | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, 555191, Camp Pendleton, CA 92055-5191 | 2019-06-05 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
Find all providers in zip 92055 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124292701 | Mona Marcella Colianno | General Practice | 1st Mlg Clr 1, Camp Pendleton, CA 92055 | 2008-04-15 |
1902083140 | Lukasz Swistun | General Practice | I Mef Hsse, Attn Mssp, Bldg 210721 C St, Camp Pendleton, CA 92055 | 2008-01-30 |
1396883633 | Donald William Hurst Jr. | General Practice | Mag 39, Camp Pendleton, CA 92055-5750 | 2007-02-01 |
1689721136 | Robert Nathan Clapp | General Practice | 328 Angeles St, Camp Pendleton, CA 92054-8255 | 2007-01-05 |
1750344305 | Huy Tan Tran | General Practice | Bldg 100 Margarita Road, Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055-5191 | 2006-04-06 |
1538152343 | Gregory P Montoya | General Practice | 22 Area Group Aid Station, Bldg 22190, Camp Pendleton, CA 92055-5627 | 2005-08-26 |
1194726943 | Jillian Rose Martin | General Practice | 1st Fssg, Mssg 15 Box 555717, Camp Pendleton, CA 92055-5717 | 2005-08-02 |
1477828861 | Michael Ryan Austin | General Practice | 22 Area Branch Medical Clinic, Camp Pendleton, Camp Pendleton, CA 92055 | 2012-03-19 |
1033311758 | Bryan Keenan | General Practice | Mag 39, Area 22 Medical, Bldg 22190, Camp Pendleton, CA 92055 | 2007-06-04 |
1194829887 | Anne Bryant Roberts | General Practice | Naval Hospital Camp Pendleton, Santa Marguerita Road, Bldg H100 Attn: Code 094, Camp Pendleton, CA 92055-5191 | 2006-09-12 |
Find all providers in CAMP PENDLETON |
City | CAMP PENDLETON |
Zip Code | 92055 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.