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Individual

MR. MICHAEL DENNIS GILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1025 E OCEAN AVE, SUITE A, LOMPOC, CA 93436
(805) 735-7621
(805) 736-5378
Mailing address
1025 E OCEAN AVE, SUITE A, LOMPOC, CA 93436
(805) 735-7621
(805) 736-5378

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G54515
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G54515
LICENSE
CA
Enumeration date
09/29/2006
Last updated
09/16/2008
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