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General NPI Number Information
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NPI Number | 1386636165
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Entity Type | Organization
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Legal Business Name | P. GILL OBSTETRICS & GYNECOLOGY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 999 S FAIRMONT AVE STE 230
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City | LODI
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State | CA
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Zip | 95240-5100
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Country | US
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Telephone | 209-465-5550
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Fax | 209-334-0127
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Provider Business Mailing Address
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Address Line | PO BOX 1090
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City | LODI
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State | CA
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Zip | 95241-1090
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Country | US
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Telephone | 209-465-5550
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Fax | 209-334-0127
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Authorized Official
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Title or Position | CEO-CORPORATION
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Name | DR. PARAM K GILL
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Credential | MD
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Telephone | 209-465-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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