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NPI Code Detail

MEDICARE: DR. TAIYE A GILLES M.D.

MEDICARE: DR. TAIYE A GILLES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician01060813AIN
2207R00000XInternal Medicine Physician01060813AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000555514OTHERINANTHEM

General Provider Information

NPI Number : 1841232733
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAIYE A GILLES M.D.
Provider Business Mailing Address
First Line : PO BOX 1104
Second Line :
City : CARDIFF BY THE SEA
State : CA
Zip : 92007-7104
Country : US
Telephone Number : 760-672-5120
Fax Number :
Provider Business Practice Location Address
First Line : 310 SANTA FE DR STE 112
Second Line :
City : ENCINITAS
State : CA
Zip : 92024-5123
Country : US
Telephone Number : 760-642-7009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 09/07/2021

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