Provider Demographics
NPI:1740325075
Name:GILMOUR, YVETTE PIGEON (PT)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:PIGEON
Last Name:GILMOUR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26042 MCNATT CT
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-6000
Mailing Address - Country:US
Mailing Address - Phone:949-583-9287
Mailing Address - Fax:
Practice Address - Street 1:1929 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6524
Practice Address - Country:US
Practice Address - Phone:949-797-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT120902251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics