| David R. Gilliam M.d. Inc | |
|
1620 Pennsylvannia Ave Ste C Fairfield CA 94533-3509 | |
| (707) 428-4878 | |
| (707) 428-0806 |
| Full Name | David R. Gilliam M.d. Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1620 Pennsylvannia Ave, Fairfield, California |
| Authorized Official Name and Position | David Roy Gilliam (OWNER) |
| Authorized Official Contact | 7074284878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David R. Gilliam M.d. Inc 1620 Pennsylvannia Ave Ste C Fairfield CA 94533-3509 Ph: (707) 428-4878 | David R. Gilliam M.d. Inc 1620 Pennsylvannia Ave Ste C Fairfield CA 94533-3509 Ph: (707) 428-4878 |
| NPI Number | 1558338491 |
|---|---|
| Provider Enumeration Date | 02/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558338491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G36497 (California) | Primary |
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