Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | A70670 | CA |
NPI | 1659378990 |
---|---|
Provider Name | Julie Renee Gilbert |
First Address | San Diego, CA 92123-4205 |
Second Address | San Diego, CA 92123-4205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 12/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I08663 | (02) |