Healthcare Provider Details

I. General information

NPI: 1306024849
Provider Name (Legal Business Name): HIMMAT S GILL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7135 N CHESTNUT AVE STE 104
FRESNO CA
93720-0362
US

IV. Provider business mailing address

7135 N CHESTNUT AVE STE 104
FRESNO CA
93720-0362
US

V. Phone/Fax

Practice location:
  • Phone: 559-447-8632
  • Fax: 559-447-8872
Mailing address:
  • Phone: 559-447-8632
  • Fax: 559-447-8872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOANNE R AUSTRUM
Title or Position: OFFICE MANAGER
Credential:
Phone: 559-447-8632