Healthcare Provider Details

I. General information

NPI: 1851152250
Provider Name (Legal Business Name): HARJEET GILL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7970 LANDER AVE STE AB
HILMAR CA
95324-8350
US

IV. Provider business mailing address

7970 LANDER AVE STE AB
HILMAR CA
95324-8350
US

V. Phone/Fax

Practice location:
  • Phone: 209-850-3500
  • Fax: 209-850-3454
Mailing address:
  • Phone: 209-850-3500
  • Fax: 209-850-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA68968
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: