Provider Demographics
NPI:1760651608
Name:SUDEEP SINGH M.D., INC
Entity Type:Organization
Organization Name:SUDEEP SINGH M.D., INC
Other - Org Name:SINGH SINUS & BREATHING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-431-9589
Mailing Address - Street 1:8839 N CEDAR AVE # 53
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1832
Mailing Address - Country:US
Mailing Address - Phone:559-431-9589
Mailing Address - Fax:559-431-4721
Practice Address - Street 1:114 N 11TH AVE
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4508
Practice Address - Country:US
Practice Address - Phone:559-587-9910
Practice Address - Fax:559-587-0487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A491470174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A491470OtherMEDICARE NUMBER
CAGR0084990Medicaid
CAGR0084990Medicaid