Provider Demographics
NPI:1457462327
Name:SINGSEN, BERNHARD HEYDER (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNHARD
Middle Name:HEYDER
Last Name:SINGSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:747 52ND ST
Mailing Address - Street 2:OPC; ROOM 4413
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-3304
Mailing Address - Fax:510-450-5678
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:OPC; ROOM 4413
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3304
Practice Address - Fax:510-450-5678
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG194132080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G19413Medicaid
CAB18585Medicare UPIN
CA00G194130Medicare ID - Type Unspecified