Provider Demographics
NPI:1730775941
Name:GILL, AMANPREET KAUR
Entity type:Individual
Prefix:
First Name:AMANPREET
Middle Name:KAUR
Last Name:GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9344 MIKO CIR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5025
Mailing Address - Country:US
Mailing Address - Phone:916-233-6411
Mailing Address - Fax:
Practice Address - Street 1:470 N AIRPORT RD
Practice Address - Street 2:
Practice Address - City:WILLOWS
Practice Address - State:CA
Practice Address - Zip Code:95988-9701
Practice Address - Country:US
Practice Address - Phone:530-934-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty