Provider Demographics
NPI:1225025760
Name:SINGH, HARBHAJAN (MD)
Entity Type:Individual
Prefix:
First Name:HARBHAJAN
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 1:330 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2720
Mailing Address - Country:US
Mailing Address - Phone:916-351-9151
Mailing Address - Fax:
Practice Address - Street 1:1140 NORMAN DR. #4
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-5900
Practice Address - Country:US
Practice Address - Phone:209-824-3158
Practice Address - Fax:209-239-1725
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC54599207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109538Medicaid
ILK18758Medicare PIN
I33594Medicare UPIN