Provider Demographics
NPI:1013180785
Name:SHYAMALI MALLICK SINGHAL, M.D., PHD, INC.
Entity Type:Organization
Organization Name:SHYAMALI MALLICK SINGHAL, M.D., PHD, INC.
Other - Org Name:MOUNTAIN VIEW SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHYAMALI
Authorized Official - Middle Name:MALLICK
Authorized Official - Last Name:SINGHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-600-7301
Mailing Address - Street 1:2500 HOSPITAL DR STE 15-1
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4106
Mailing Address - Country:US
Mailing Address - Phone:650-282-3000
Mailing Address - Fax:650-963-5071
Practice Address - Street 1:2500 HOSPITAL DR STE 15-1
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-282-3000
Practice Address - Fax:650-963-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79445208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH67382Medicare UPIN
CA00A794450Medicare PIN