Provider Demographics
NPI:1578792008
Name:SHIVDYAL SINGH, MD., INC.
Entity Type:Organization
Organization Name:SHIVDYAL SINGH, MD., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD.
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVDYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-905-5583
Mailing Address - Street 1:4955 VAN NUYS BLVD
Mailing Address - Street 2:SUITE # 719
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1801
Mailing Address - Country:US
Mailing Address - Phone:818-905-5583
Mailing Address - Fax:818-906-3141
Practice Address - Street 1:4955 VAN NUYS BLVD
Practice Address - Street 2:SUITE # 719
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1801
Practice Address - Country:US
Practice Address - Phone:818-905-5583
Practice Address - Fax:818-906-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A371180Medicaid
CA00A371180Medicaid