Provider Demographics
NPI:1437868023
Name:SINGH, AMANDEEP (RT)
Entity Type:Individual
Prefix:
First Name:AMANDEEP
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 576783
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-6783
Mailing Address - Country:US
Mailing Address - Phone:209-572-5888
Mailing Address - Fax:209-665-7955
Practice Address - Street 1:2096 FELSINA AVE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-8111
Practice Address - Country:US
Practice Address - Phone:209-572-5888
Practice Address - Fax:209-665-7955
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHF00094368247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist