Provider Demographics
NPI:1326200726
Name:SINGH, PRADEEP (MD)
Entity Type:Individual
Prefix:
First Name:PRADEEP
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 1:31 PALMER DR
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-7229
Mailing Address - Country:US
Mailing Address - Phone:239-810-3529
Mailing Address - Fax:239-343-5348
Practice Address - Street 1:31 PALMER DR
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-7229
Practice Address - Country:US
Practice Address - Phone:239-810-3529
Practice Address - Fax:239-343-5348
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL105044207R00000X
FLME105044208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL146OUOtherBC/BS
FL002120600Medicaid
FL146OUOtherBC/BS