Provider Demographics
NPI:1700940533
Name:GILL, HARPAL SINGH (DC)
Entity Type:Individual
Prefix:DR
First Name:HARPAL
Middle Name:SINGH
Last Name:GILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CALLE LOYOLA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-7058
Mailing Address - Country:US
Mailing Address - Phone:312-933-8912
Mailing Address - Fax:
Practice Address - Street 1:4299 MACARTHUR BLVD STE 106
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2019
Practice Address - Country:US
Practice Address - Phone:949-222-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL300160385-0001OtherUNITED HEALTHCARE ID
IL300160385-0002OtherUNITED HEALTHCARE ID #
IL01634775OtherBCBS PROVIDER NUMBER
IL300160385-0002OtherUNITED HEALTHCARE ID #