Provider Demographics
NPI:1134332992
Name:GIL, ALMA LETICIA
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:LETICIA
Last Name:GIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALMA
Other - Middle Name:LETICIA
Other - Last Name:ESPINOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 ROSEWOOD AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10730 HENDERSON ROAD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004
Practice Address - Country:US
Practice Address - Phone:805-647-1147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 8106174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist