Provider Demographics
NPI:1629787122
Name:GILL, GURSIMRAN KAUR (RPH)
Entity Type:Individual
Prefix:
First Name:GURSIMRAN
Middle Name:KAUR
Last Name:GILL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4562 SUGAR OAK DR
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-8666
Mailing Address - Country:US
Mailing Address - Phone:209-606-5012
Mailing Address - Fax:
Practice Address - Street 1:4562 SUGAR OAK DR
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-8666
Practice Address - Country:US
Practice Address - Phone:209-606-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist