Provider Demographics
NPI:1780662940
Name:CUTLER, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:CUTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3953 W STETSON AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-9687
Mailing Address - Country:US
Mailing Address - Phone:951-652-4343
Mailing Address - Fax:951-765-6039
Practice Address - Street 1:3953 W STETSON AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-9687
Practice Address - Country:US
Practice Address - Phone:951-652-4343
Practice Address - Fax:951-765-6039
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG25979207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-3759073OtherTAX ID
CAG25979OtherMEDICAL BOARD
CAOOG259790Medicaid
CA756181688OtherRAILROAD MEDICARE
CA756181688OtherRAILROAD MEDICARE
AC8592431OtherDEA
CAG25979OtherMEDICAL BOARD
CAOOG259790Medicare ID - Type Unspecified
A42861Medicare UPIN