Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0157 | CA |
NPI | 1093816530 |
---|---|
Provider Name | Ms. Susan Scott Gill |
First Address | Orange, CA 92867-2494 |
Second Address | Santa Ana, CA 92705-1372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 04/09/2009 |