Provider Demographics
NPI:1376119453
Name:GILL, GURPINDER K (RN)
Entity Type:Individual
Prefix:
First Name:GURPINDER
Middle Name:K
Last Name:GILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 SONORA WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3854
Mailing Address - Country:US
Mailing Address - Phone:510-857-6119
Mailing Address - Fax:
Practice Address - Street 1:2800 BENEDICT DR
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-6840
Practice Address - Country:US
Practice Address - Phone:510-357-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95085121163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse