Healthcare Provider Details

I. General information

NPI: 1538579362
Provider Name (Legal Business Name): KAMALVIR GILL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH ST FL 5
SAN FRANCISCO CA
94158-2545
US

IV. Provider business mailing address

550 16TH ST FL 5
SAN FRANCISCO CA
94158-2545
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3380
  • Fax:
Mailing address:
  • Phone: 510-428-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberA193772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: