Provider Demographics
NPI:1447575097
Name:MANGAT, GEETESHWAR SINGH (MD)
Entity Type:Individual
Prefix:
First Name:GEETESHWAR
Middle Name:SINGH
Last Name:MANGAT
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 1:4792 PARKSCAPE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-5704
Mailing Address - Country:US
Mailing Address - Phone:951-785-6201
Mailing Address - Fax:
Practice Address - Street 1:9500 STOCKDALE HWY STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3621
Practice Address - Country:US
Practice Address - Phone:661-840-2222
Practice Address - Fax:661-840-2222
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122865207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine