Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mario Gutierrez, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1801283635

Dr. Mario Gutierrez, MD is an Internal Medicine in Peoria, Illinois. Qualified in 2015, 11 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment.

Years since qualifying
11
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1109 W Main St Apt 505
Peoria, IL 61606-1385
Phone: (714) 349-5704
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1801283635
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 20, 2015
Last updated in NPPESDecember 6, 2021
Mailing address13571 Mashona Ave, Chino, CA 91710-8345

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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