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General NPI Number Information
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NPI Number | 1659788578
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Entity Type | Organization
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Legal Business Name | SIMRIN GILL
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 2600 MITCHELL RD STE G
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City | CERES
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State | CA
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Zip | 95307-9466
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Country | US
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Telephone | 209-585-4500
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Fax | 209-320-3513
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Provider Business Mailing Address
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Address Line | 2600 MITCHELL RD STE G
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City | CERES
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State | CA
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Zip | 95307-9468
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Country | US
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Telephone | 209-585-4500
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Fax | 209-320-3513
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Authorized Official
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Title or Position | OWNER/ CASHIER
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Name | SIMRIN GILL
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Credential |
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Telephone | 209-604-5533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 51923
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License Number State | CA
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