Provider Demographics
NPI:1609972983
Name:GILL, PARKASH (MD)
Entity Type:Individual
Prefix:DR
First Name:PARKASH
Middle Name:
Last Name:GILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 31218
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0218
Mailing Address - Country:US
Mailing Address - Phone:626-457-5839
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO STREET
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4528
Practice Address - Country:US
Practice Address - Phone:626-457-5839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36570207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ50018ZOtherGROUP BLUE SHIELD
CA1356390009OtherGROUP NPI
CAGR0016910OtherGROUP MEDICAID PIN
CA06E2774OtherGROUP CHAMPUS
CACE1617OtherGROUP RAILROAD MEDICARE
CAW11675OtherGROUP MEDICARE PIN
CA00A365700Medicaid
CAW11675OtherGROUP MEDICARE PIN
CAWA36570BMedicare PIN