Provider Demographics
NPI:1407297146
Name:SINGH, JASPREET (MD)
Entity Type:Individual
Prefix:
First Name:JASPREET
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 1:1120 W AVENUE M4
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1432
Mailing Address - Country:US
Mailing Address - Phone:661-480-2377
Mailing Address - Fax:661-480-2378
Practice Address - Street 1:1120 W AVENUE M4
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1432
Practice Address - Country:US
Practice Address - Phone:661-480-2377
Practice Address - Fax:661-480-2378
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ565142081P2900X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ393248Medicaid