Healthcare Provider Details

I. General information

NPI: 1932125135
Provider Name (Legal Business Name): GURPREET K PADAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S SAN MATEO DR STE 106
SAN MATEO CA
94401-3840
US

IV. Provider business mailing address

101 S SAN MATEO DR STE 106
SAN MATEO CA
94401-3840
US

V. Phone/Fax

Practice location:
  • Phone: 650-360-9309
  • Fax: 650-360-0781
Mailing address:
  • Phone: 650-360-9309
  • Fax: 650-360-0781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA88960
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA88960
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberA88960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: