Provider Demographics
NPI:1225442205
Name:GILL, KEIKO (DC)
Entity Type:Individual
Prefix:
First Name:KEIKO
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 CALIFORNIA AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1607
Mailing Address - Country:US
Mailing Address - Phone:650-321-7193
Mailing Address - Fax:
Practice Address - Street 1:480 CALIFORNIA AVE STE 103
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306
Practice Address - Country:US
Practice Address - Phone:650-321-7193
Practice Address - Fax:877-763-3234
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK589111N00000X
CA22682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor