Provider Demographics
NPI:1114085362
Name:SINGH, DAVINDER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVINDER
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 WARNER AVE
Mailing Address - Street 2:SUITE 268
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7512
Mailing Address - Country:US
Mailing Address - Phone:714-540-9911
Mailing Address - Fax:714-549-9720
Practice Address - Street 1:11100 WARNER AVE
Practice Address - Street 2:SUITE 268
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7512
Practice Address - Country:US
Practice Address - Phone:714-540-9911
Practice Address - Fax:714-549-9720
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25451207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912029901OtherGROUP NPI NUMBER
CAA25451OtherSTATE ID NUMBER
W1608OtherGROUP MEDICARE PTAN
CAZZZ71176ZMedicaid
WA25451COtherMEDICARE PTAN
1912029901OtherGROUP NPI NUMBER