Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D0047320 | MD |
N | 111NI0900X | Internist | D0047320 | MD |
Y | 208D00000X | General Practice Physician | G69466 | CA |
NPI | 1043301195 |
---|---|
Provider Name | Dr. Michael Kenneth Gilson |
First Address | La Jolla, CA 92093-0736 |
Second Address | La Jolla, CA 92093-0736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 07/03/2012 |