Individual
AMBER HECKART GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
260 HOSPITAL DR STE 103, UKIAH, CA 95482-4568
(707) 463-7470
Mailing address
260 HOSPITAL DR STE 103, UKIAH, CA 95482-4568
(707) 463-7470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2017-01980
NC
207Q00000X
Family Medicine Physician
82249
SC
207Q00000X
Family Medicine Physician
Primary
A169012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
822499
—
SC
01
—
SCF4033365
MEDICARE PIN
SC
01
—
SCF4036067
MEDICARE PIN
SC
01
—
SCF4036084
MEDICARE PIN
SC
01
—
SCF4036121
MEDICARE PIN
SC
01
—
SCF403J577
MEDICARE PIN
SC
Enumeration date
04/12/2016
Last updated
07/28/2020
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