Provider Demographics
NPI:1710982608
Name:BRAR, NIRMAL SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRMAL
Middle Name:SINGH
Last Name:BRAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E HERNDON AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3100
Mailing Address - Country:US
Mailing Address - Phone:559-376-7921
Mailing Address - Fax:559-336-4176
Practice Address - Street 1:1111 E HERNDON AVE STE 115
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3100
Practice Address - Country:US
Practice Address - Phone:559-376-7921
Practice Address - Fax:559-336-4176
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA739842084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI11060Medicare UPIN