Provider Demographics
NPI:1104674407
Name:GURPREET K PADAM MD PC
Entity type:Organization
Organization Name:GURPREET K PADAM MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GURPREET
Authorized Official - Middle Name:K
Authorized Official - Last Name:PADAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-360-9309
Mailing Address - Street 1:101 S SAN MATEO DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3840
Mailing Address - Country:US
Mailing Address - Phone:650-360-9309
Mailing Address - Fax:
Practice Address - Street 1:101 S SAN MATEO DR STE 106
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3840
Practice Address - Country:US
Practice Address - Phone:650-360-9309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty