Healthcare Provider Details

I. General information

NPI: 1467956607
Provider Name (Legal Business Name): RACHEL H GILMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CITY BLVD W STE 1600
ORANGE CA
92868-5903
US

IV. Provider business mailing address

333 CITY BLVD W STE 1600
ORANGE CA
92868-5903
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5532
  • Fax:
Mailing address:
  • Phone: 714-456-5532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number308524
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: