Provider Demographics
NPI:1427388800
Name:SINGH, MUKUNDA NARAJAN (MSTOM)
Entity Type:Individual
Prefix:
First Name:MUKUNDA
Middle Name:NARAJAN
Last Name:SINGH
Suffix:
Gender:M
Credentials:MSTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28756 RIKI CT
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-4663
Mailing Address - Country:US
Mailing Address - Phone:619-889-6076
Mailing Address - Fax:
Practice Address - Street 1:28756 RIKI CT
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-4663
Practice Address - Country:US
Practice Address - Phone:619-889-6076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13194171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist