Healthcare Provider Details

I. General information

NPI: 1023241189
Provider Name (Legal Business Name): DENISE ANN GILPIN LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16485 LAGUNA CANYON RD STE 250
IRVINE CA
92618-3837
US

IV. Provider business mailing address

16485 LAGUNA CANYON RD STE 250
IRVINE CA
92618-3837
US

V. Phone/Fax

Practice location:
  • Phone: 760-622-4781
  • Fax: 760-731-9628
Mailing address:
  • Phone: 760-622-4781
  • Fax: 760-731-9628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM92
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: