Provider Demographics
NPI:1073018891
Name:GILLES, LOUIS D (DPM)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:D
Last Name:GILLES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SANTA FE DR STE 112
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5123
Mailing Address - Country:US
Mailing Address - Phone:760-642-7009
Mailing Address - Fax:
Practice Address - Street 1:310 SANTA FE DR STE 112
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5123
Practice Address - Country:US
Practice Address - Phone:760-642-7009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-25
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAEL6796213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery