Provider Demographics
NPI:1790324481
Name:ERASTO GUTIERREZ MD INC
Entity Type:Organization
Organization Name:ERASTO GUTIERREZ MD INC
Other - Org Name:POMONA URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARCHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-729-5079
Mailing Address - Street 1:1749 N GAREY AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2913
Mailing Address - Country:US
Mailing Address - Phone:909-729-5079
Mailing Address - Fax:909-729-5081
Practice Address - Street 1:1749 N GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2913
Practice Address - Country:US
Practice Address - Phone:909-729-5079
Practice Address - Fax:909-729-5081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERASTO GUTIERREZ MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-30
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty