Gillispie, Mark A
Gillispie, Mark A is an individual health care provider with primary practice located at 82227 Us Highway 111 Suite B-2, Indio CA 92201-5667. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gillispie, Mark A can be contacted via phone (760) 347-6636.Contact Information
Primary practice address
82227 Us Highway 111 Suite B-2
Indio CA 92201-5667
Phone: (760) 347-6636
Fax: (760) 342-5987
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 8413T | California |
Profile Details
| NPI number | 1043391899 |
|---|---|
| LBN Legal business name | Gillispie, Mark A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Mar 13th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043391899 | NPPES |
| California | MEDICAID | SD0084130 |
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