Healthcare Provider Details

I. General information

NPI: 1265626378
Provider Name (Legal Business Name): KANWAR PARTAP SINGH GILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KANWAR GILL MD

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 FRESNO ST STE 101
FRESNO CA
93706-3641
US

IV. Provider business mailing address

302 FRESNO ST STE 101
FRESNO CA
93706-3641
US

V. Phone/Fax

Practice location:
  • Phone: 559-457-5700
  • Fax: 559-457-5790
Mailing address:
  • Phone: 559-457-5700
  • Fax: 559-457-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA109884
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: