Provider Demographics
NPI:1740010628
Name:GIL, DOUGLAS SALVADOR
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:SALVADOR
Last Name:GIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4542 SAN CARLOS AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-4730
Mailing Address - Country:US
Mailing Address - Phone:925-354-2023
Mailing Address - Fax:
Practice Address - Street 1:2575 DEPOT RD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-2341
Practice Address - Country:US
Practice Address - Phone:510-784-5874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)