Provider Demographics
NPI:1265626378
Name:GILL, KANWAR PARTAP SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:KANWAR PARTAP
Middle Name:SINGH
Last Name:GILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KANWAR
Other - Middle Name:
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8408 N ANN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4987
Mailing Address - Country:US
Mailing Address - Phone:559-447-8490
Mailing Address - Fax:
Practice Address - Street 1:8408 N ANN AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-4987
Practice Address - Country:US
Practice Address - Phone:559-447-8490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109884207Q00000X, 207P00000X, 2083P0901X, 208D00000X, 209800000X, 261QR1100X, 261QU0200X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No209800000XAllopathic & Osteopathic PhysiciansLegal Medicine
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA109884OtherPHYSICIAN AND SURGEON LICENSE (MEDICAL BOARD OF CALIFORNIA)
CAA109884OtherPHYSICIAN AND SURGEON LICENSE