Healthcare Provider Details

I. General information

NPI: 1912433202
Provider Name (Legal Business Name): EKJYOT GILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5329 OFFICE CENTER CT STE 110
BAKERSFIELD CA
93309-7400
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 815-373-0030
  • Fax: 815-247-3233
Mailing address:
  • Phone: 323-442-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA171592
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License NumberA171592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: