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General NPI Number Information
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NPI Number | 1821294596
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Entity Type | Organization
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Legal Business Name | MESA WEST MEDICAL INC
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 02/17/2014
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Provider Practice Location Address
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Address Line | 8327 BRIMHALL ROAD BLDG 700 SUITE 704
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City | BAKERSFIELD
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State | CA
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Zip | 93312
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Country | US
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Telephone | 661-617-6750
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Fax | 661-617-6760
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Provider Business Mailing Address
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Address Line | 8327 BRIMHALL ROAD BLDG 700 SUITE 704
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City | BAKERSFIELD
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State | CA
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Zip | 93312-0000
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Country | US
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Telephone | 661-617-6750
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Fax | 661-617-6760
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM EDWARD GILLI
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Credential | M.D.
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Telephone | 661-617-6750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G53033
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License Number State | CA
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