Provider Demographics
NPI:1710144423
Name:SINGH, ABHA GOYAL (MB, BS)
Entity Type:Individual
Prefix:DR
First Name:ABHA
Middle Name:GOYAL
Last Name:SINGH
Suffix:
Gender:F
Credentials:MB, BS
Other - Prefix:
Other - First Name:ABHA
Other - Middle Name:
Other - Last Name:GOYAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9500 GILMAN DR DEPT 656
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0656
Mailing Address - Country:US
Mailing Address - Phone:858-534-2359
Mailing Address - Fax:
Practice Address - Street 1:PERLMAN AMBULATORY CARE CLINIC
Practice Address - Street 2:9350 CAMPUS POINT DRIVE
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0001
Practice Address - Country:US
Practice Address - Phone:858-657-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN53991207R00000X
IAR-8257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNPOO992478OtherMCR RAILROAD MEDICARE
MN110014565Medicare PIN