Provider Demographics
NPI:1942793732
Name:GILL, HARKIRAN (DO)
Entity Type:Individual
Prefix:
First Name:HARKIRAN
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 E RIVER PARK PL W STE 507
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1565
Mailing Address - Country:US
Mailing Address - Phone:559-603-7389
Mailing Address - Fax:
Practice Address - Street 1:45 E RIVER PARK PL W STE 507
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1565
Practice Address - Country:US
Practice Address - Phone:559-603-7389
Practice Address - Fax:559-451-3661
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A18939207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program