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General NPI Number Information
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NPI Number | 1891246153
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Entity Type | Organization
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Legal Business Name | PACIFIC INFECTIOUS DISEASES, INC.
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 1024 JAYHAWK WAY
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City | MODESTO
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State | CA
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Zip | 95358-6714
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Country | US
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Telephone | 209-248-7345
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Fax |
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Provider Business Mailing Address
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Address Line | 1024 JAYHAWK WAY
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City | MODESTO
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State | CA
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Zip | 95358-6714
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Country | US
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Telephone | 209-248-7345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NAVNEET KAUR GILL
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Credential | M.D.
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Telephone | 209-248-7345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | A138814
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License Number State | CA
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