Lynn M Gill

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

152W00000X Issued in CA

Legal business name

LYNN M GILL

Practice address

5284 Highway 49 North
Suite 1
Mariposa, CA 95338-9501

Phone

(209) 966-3684

Fax

(209) 966-3601

NPI assigned

Dec 15, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lynn Matthew Gill, O.D.

Title

Owner

Phone

(209) 966-3684

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• L M GILL O D Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1811266190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5284 HIGHWAY 49 NORTH",
            "address_2": "SUITE 1",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389501",
            "telephone_number": "209-966-3684",
            "fax_number": "209-966-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5284 HIGHWAY 49 NORTH",
            "address_2": "SUITE 1",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389501",
            "telephone_number": "209-966-3684",
            "fax_number": "209-966-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN M GILL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-966-3684",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "152W00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0051250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L M GILL O D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Eyewear Supplier in Mariposa, CA
• Providers in Mariposa, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.