Provider Demographics
NPI:1134160203
Name:GILBERT, PATRICIA LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LOUISE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944-1770
Mailing Address - Country:US
Mailing Address - Phone:619-442-4000
Mailing Address - Fax:619-579-1328
Practice Address - Street 1:1679 E MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5212
Practice Address - Country:US
Practice Address - Phone:619-442-4000
Practice Address - Fax:619-579-1328
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0674412084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G674411Medicaid
F92465Medicare UPIN
CA00G674411Medicaid