# MICHAEL D. GILL MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093039372
- **Authorized official:** MR. MICHAEL DENNIS GILL MD (MD, OWNER)
- **Authorized official phone:** (805) 735-7621

## Contact information

- **Practice address:** 1025 E. OCEAN AVE, STE. A, LOMPOC, CA 93436-7088
- **Practice address phone:** (805) 735-7621
- **Practice address fax:** (805) 736-5378
- **Mailing address:** 1025 E. OCEAN AVE,, STE A, LOMPOC, CA 93436-7088
- **Mailing address phone:** (805) 735-7621
- **Mailing address fax:** (805) 736-5378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G54515 | CA | Yes |

## Other

- **Enumeration date:** 03/16/2010
- **Last updated:** 03/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | G54515 | LICENSE\# | CA |