Organization
LYNN M GILL
Active
Other names
L M GILL O D
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LYNN MATTHEW GILL O.D. (OWNER)
(209) 966-3684
Entity
Organization
Contact information
Practice address
5284 HIGHWAY 49 NORTH, SUITE 1, MARIPOSA, CA 95338-9501
(209) 966-3684
(209) 966-3601
Mailing address
5284 HIGHWAY 49 NORTH, SUITE 1, MARIPOSA, CA 95338-9501
(209) 966-3684
(209) 966-3601
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
152W00000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0051250
—
CA
Enumeration date
12/15/2011
Last updated
04/12/2012
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