Organization
DAVID R. GILLIAM M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROY GILLIAM M.D. (OWNER)
(707) 428-4878
Entity
Organization
Contact information
Practice address
1620 PENNSYLVANNIA AVE, STE C, FAIRFIELD, CA 94533-3509
(707) 428-4878
(707) 428-0806
Mailing address
1620 PENNSYLVANNIA AVE, STE C, FAIRFIELD, CA 94533-3509
(707) 428-4878
(707) 428-0806
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G36497
CA
Other
Enumeration date
02/28/2006
Last updated
08/22/2020
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