Healthcare Provider Details

I. General information

NPI: 1184630774
Provider Name (Legal Business Name): MARK ALLEN GILBERT PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 SAN JOSE ST STE 301
SALINAS CA
93901-3928
US

IV. Provider business mailing address

212 SAN JOSE ST STE 301
SALINAS CA
93901-3928
US

V. Phone/Fax

Practice location:
  • Phone: 831-759-3289
  • Fax: 831-753-5188
Mailing address:
  • Phone: 831-649-1000
  • Fax: 831-649-4962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00344
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA20342
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: