Provider Demographics
NPI:1699721258
Name:GILBERT, MARY ANN (MA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 E PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4302
Mailing Address - Country:US
Mailing Address - Phone:562-698-0581
Mailing Address - Fax:562-696-9798
Practice Address - Street 1:13121 E PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4302
Practice Address - Country:US
Practice Address - Phone:562-698-0581
Practice Address - Fax:562-696-9798
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU582231H00000X
CAHA1594237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ82397ZMedicaid
CAAU582Medicare ID - Type Unspecified