Organization
SCOTT GILLIN MD INC
Active
Other names
Seaside Ketamine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT GILLIN MD (OWNER)
(858) 254-0512
Entity
Organization
Contact information
Practice address
1953 SAN ELIJO AVE STE 200, CARDIFF, CA 92007-2348
(858) 215-2618
Mailing address
13990 MERCADO DR, DEL MAR, CA 92014-3124
(858) 254-0512
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207LP3000X
Pediatric Anesthesiology Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
08/09/2025
Last updated
12/23/2025
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