| Mark A Gillispie O D Inc | |
|
52565 Harrison St., Suite 105, Coachella, CA 92236 | |
| (760) 398-1500 | |
| (760) 398-8474 |
| Full Name | Mark A Gillispie O D Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 52565 Harrison St., Coachella, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467621185 | NPI | - | NPPES |
| GSD004740 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 8413T (California) | Primary |
| 332H00000X | Eyewear Supplier | 8413T (California) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A Gillispie O D Inc 82227 Us Highway 111, Suite B-2, Indio, CA 92201-5667 Ph: (760) 347-6636 | Mark A Gillispie O D Inc 52565 Harrison St., Suite 105, Coachella, CA 92236 Ph: (760) 398-1500 |
Dr. Monica Etniel, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 52565 Cesar Chavez St Ste 105, Coachella, CA 92236 Phone: 760-347-6636 Fax: 844-833-6644 | |
Mrs. Lilia F Armijo, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 52565 Harrison St Ste 106, Coachella, CA 92236 Phone: 760-398-2000 Fax: 760-398-2011 | |
Javier Armijo, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 52565 Harrison St Ste 106, Coachella, CA 92236 Phone: 760-398-2000 Fax: 760-398-2011 |