Basic Information
| Provider Information | |||||||||
| NPI: | 1679092498 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILMOUR | ||||||||
| FirstName: | EILEEN | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 S TWIN OAKS VALLEY RD | ||||||||
| Address2: | APT 296 | ||||||||
| City: | SAN MARCOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920787328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067089489 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5619 CAROLINA BEACH RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284122814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107900212 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2017 | ||||||||
| LastUpdateDate: | 07/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2492 | NC | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.