Healthcare Provider Details

I. General information

NPI: 1285838359
Provider Name (Legal Business Name): AMANDEEP SINGH GILL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AMANDEEP SINGH M.D

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W HOSPITAL RD
FRENCH CAMP CA
95231-9693
US

IV. Provider business mailing address

PO BOX 1020
STOCKTON CA
95201-3120
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-6175
  • Fax: 209-468-6337
Mailing address:
  • Phone: 209-468-9063
  • Fax: 209-468-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberA116016
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA116016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: