Provider Demographics
NPI:1235336710
Name:VIRK, PAL SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:PAL
Middle Name:SINGH
Last Name:VIRK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5556
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93755-5556
Mailing Address - Country:US
Mailing Address - Phone:559-665-6680
Mailing Address - Fax:559-434-2090
Practice Address - Street 1:VALLEY STATE PRISON FOR WOMEN
Practice Address - Street 2:21633 AVENUE 24
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610
Practice Address - Country:US
Practice Address - Phone:559-665-6100
Practice Address - Fax:559-665-6119
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63264207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A632640Medicaid
CA00A632640Medicare ID - Type Unspecified
CA00A632640Medicaid