Provider Demographics
NPI:1275968091
Name:GUTIERREZ, CHRISTOPHER ALLAN (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALLAN
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11478 BROOKRUN CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-5119
Mailing Address - Country:US
Mailing Address - Phone:951-233-3533
Mailing Address - Fax:
Practice Address - Street 1:11478 BROOKRUN CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-5119
Practice Address - Country:US
Practice Address - Phone:951-233-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program