Provider Demographics
NPI:1487045530
Name:SINGH FAMILY MEDICAL CLINIC INCORPORATED
Entity Type:Organization
Organization Name:SINGH FAMILY MEDICAL CLINIC INCORPORATED
Other - Org Name:SINGH FAMILY MEDICAL CLINIC INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDERJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-817-5988
Mailing Address - Street 1:9900 STOCKDALE HWY
Mailing Address - Street 2:STE 205
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3632
Mailing Address - Country:US
Mailing Address - Phone:661-817-5988
Mailing Address - Fax:818-743-7449
Practice Address - Street 1:9900 STOCKDALE HWY
Practice Address - Street 2:STE 205
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3632
Practice Address - Country:US
Practice Address - Phone:661-817-5988
Practice Address - Fax:818-743-7449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93256305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGD750AMedicare UPIN