Healthcare Provider Details

I. General information

NPI: 1558930677
Provider Name (Legal Business Name): JASVIR SINGH GILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JASVIR SINGH GILL

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 W PUTNAM AVE
PORTERVILLE CA
93257-3320
US

IV. Provider business mailing address

2265 S CLAREMONT AVE
FRESNO CA
93727-6533
US

V. Phone/Fax

Practice location:
  • Phone: 559-784-1110
  • Fax:
Mailing address:
  • Phone: 559-250-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA193072
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA193072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: