MEDICARE: GAGANDEEP KAUR GILL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0122X	Plastic and Reconstructive Surgery Physician	NP95028709	CA
2	363LF0000X	Family Nurse Practitioner	NP95028709	CA

General Provider Information

NPI Number	:	1174372577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAGANDEEP KAUR GILL NP

Provider Business Mailing Address
First Line	:	23673 PARK CAPRI UNIT 42
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1629
Country	:	US
Telephone Number	:	661-717-0951
Fax Number	:

Provider Business Practice Location Address
First Line	:	29229 CANWOOD ST STE 101
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1503
Country	:	US
Telephone Number	:	818-336-1295
Fax Number	:	818-337-1285

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2024
Last Update Date	:	10/01/2025

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