Provider Demographics
NPI:1417958208
Name:SINGH, BACHOO (MD)
Entity Type:Individual
Prefix:
First Name:BACHOO
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 1:2700 NE 14TH ST
Mailing Address - Street 2:#101
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-3561
Mailing Address - Country:US
Mailing Address - Phone:954-942-4122
Mailing Address - Fax:954-942-1998
Practice Address - Street 1:2700 NE 14TH ST
Practice Address - Street 2:#101
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-3561
Practice Address - Country:US
Practice Address - Phone:954-942-4122
Practice Address - Fax:954-942-1998
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50887207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A07702Medicare UPIN
FL04416AMedicare ID - Type Unspecified