Provider Demographics
NPI:1578738365
Name:SINGH, MANDEEP KAUR (MD)
Entity Type:Individual
Prefix:MISS
First Name:MANDEEP
Middle Name:KAUR
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 803
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:949-753-9000
Mailing Address - Fax:949-753-5044
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 803
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618
Practice Address - Country:US
Practice Address - Phone:949-753-9000
Practice Address - Fax:949-753-5044
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.124614208000000X
CAA103103208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics