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General NPI Number Information
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NPI Number | 1265099642
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Entity Type | Individual
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Provider Name | ANILDEEP SINGH GILL
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Gender | Male
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Dates
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Enumeration Date | 05/21/2019
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 1115 S SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3940
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Country | US
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Telephone | 626-962-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 950 E 3RD ST APT 2422
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City | LOS ANGELES
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State | CA
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Zip | 90013-2688
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Country | US
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Telephone | 916-204-3003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19699
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19699
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License Number State | CA
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