Provider Demographics
NPI:1124104237
Name:HARMADEEP K GILL MEDICAL CORPORATION
Entity type:Organization
Organization Name:HARMADEEP K GILL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMANDEEP
Authorized Official - Middle Name:K
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-942-5400
Mailing Address - Street 1:PO BOX 26750
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-6750
Mailing Address - Country:US
Mailing Address - Phone:661-942-5400
Mailing Address - Fax:
Practice Address - Street 1:43807 10TH STREET WEST
Practice Address - Street 2:SUITE C
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4805
Practice Address - Country:US
Practice Address - Phone:661-942-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0099251Medicaid
CADB1763Medicare PIN
CAW16694AMedicare PIN