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General NPI Number Information
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NPI Number | 1730939851
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Entity Type | Organization
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Legal Business Name | GREG GILES, O.D., INC.
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 7863 LA MESA BLVD STE 202
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City | LA MESA
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State | CA
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Zip | 91942-6708
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Country | US
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Telephone | 619-405-8381
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Fax | 619-399-2507
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Provider Business Mailing Address
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Address Line | 7867 ORIEN AVE
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City | LA MESA
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State | CA
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Zip | 91941-6300
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Country | US
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Telephone | 619-405-8381
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Fax | 619-399-2507
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY E GILES
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Credential | O.D.
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Telephone | 619-405-8381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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