MARK A GILLISPIE O D INC (NPI# 1467621185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467621185 |
| Entity Type | Organization |
| Organization Name | MARK A GILLISPIE O D INC |
| Practice Address |
52565 Harrison St. Suite 105 Coachella CA 92236 |
| Mailing Address |
82227 Us Highway 111 Suite B-2 Indio CA 92201-5667 |
| Practice Telephone | 7603981500 |
| Practice Fax Number | 7603988474 |
| Mailing Telephone | 7603476636 |
| Mailing Fax Number | 7603425987 |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2009-06-12 |
| Authorized Official Name | DR. MARK A GILLISPIE (OWNER / DOCTOR) |
| Authorized Official Telephone | 7603476636 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | 8413T | CA | Suppliers |
| Y | 152W00000X | Optometrist | 8413T | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GSD004740 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053492744 | Mark A Gillispie O D Inc | Eyewear Supplier (Equipment, not the service) | 82227 Us Highway 111, Suite B-2, Indio, CA 92201-5667 | 2006-10-18 |
| Street Address |
52565 HARRISON ST. SUITE 105 |
| City | COACHELLA |
| State | CA |
| Zip Code | 92236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710518915 | Phong Phan | Pharmacist | 84 010 Avenue 50, Coachella, CA 92236 | 2020-01-28 |
| 1518511500 | Sally Mireles | Counselor | 84109 La Jolla, Coachella, CA 92236 | 2019-07-29 |
| 1174185318 | Laura Castillo-dominguez | Licensed Vocational Nurse | 83113 Los Cabos Ave, Coachella, CA 92236 | 2019-07-08 |
| 1003390519 | Jennifer Le | Registered Nurse | 49-111 Ca-111 #6a, Coachella, CA 92236 | 2018-09-20 |
| 1700302502 | Latino Commission On Alcohol and Drug Abuse Services | Marriage & Family Therapist | 1612 First St., Coachella, CA 92236 | 2017-08-14 |
| 1467993279 | Jose Ramon Ledezma | Prosthetic/Orthotic Supplier | 84475 Goya Dr, Coachella, CA 92236 | 2017-03-13 |
| 1144622432 | Telecare Corporation | Psychiatric Unit | 49-708 Redondo Poniente, Coachella, CA 92236 | 2014-09-18 |
| 1851708762 | Juanita Ferro | Psychiatric Unit | 52371 Dos Palmas, Coachella, CA 92236 | 2014-07-14 |
| 1932519964 | Gloria Graham | Family Medicine | 50249 Harrison St, Coachella, CA 92236 | 2014-04-29 |
| 1326489121 | Alma Elizabeth Guadarrama Hernandez | Social Worker | 49211 Grapefruit Blvd Ste 5&6, Coachella, CA 92236 | 2013-07-10 |
| Find all providers in zip 92236 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801239777 | Lilia F Armijo | Optometrist | 52565 Harrison St Ste 106, Coachella, CA 92236-1534 | 2013-04-10 |
| 1861947111 | Javier Armijo | Optometrist | 52565 Harrison St Ste 106, Coachella, CA 92236-1534 | 2016-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183428 | Ashley Park | Optometrist | 386 S Green Valley Rd Ste 2, Watsonville, CA 95076-3007 | 2020-10-30 |
| 1053911842 | Michael Guerret | Optometrist | 4130 N Viking Way # 110, Long Beach, CA 90808-1402 | 2020-10-29 |
| 1912506155 | Minati Desai Acharya, O.d., Optometric Corporation | Optometrist | 117 Pelton Center Way, San Leandro, CA 94577-4815 | 2020-10-20 |
| 1740888627 | Jennifer Ngo | Optometrist | 3217 W 153rd St, Gardena, CA 90249-4011 | 2020-10-13 |
| 1649878521 | Jennie Lin | Optometrist | 12914 Cranleigh St, Cerritos, CA 90703-7245 | 2020-10-13 |
| 1962009464 | Jyoti Patel | Optometrist | 1701 Gaffey St., San Pedro, CA 90731 | 2020-10-07 |
| 1114524196 | Kenneth E. Sweeney, O.d., Inc. | Optometrist | 825 Pollard Rd Ste 208, Los Gatos, CA 95032-1435 | 2020-10-03 |
| 1316544364 | Chelsey Kimiko Honma | Optometrist | 3151 Airway Ave Ste M3, Costa Mesa, CA 92626-4626 | 2020-10-02 |
| 1437766920 | Mary Mekhael | Optometrist | 5901 Center Dr Apt 456, Los Angeles, CA 90045-8969 | 2020-09-28 |
| 1013524677 | Jennifer Dang, O.d., A Professional Corporation | Optometrist | 301 S Western Ave Ste 103, Los Angeles, CA 90020-3816 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.