Provider Demographics
NPI:1861459646
Name:RAGHVENDRA P SINGH DO
Entity Type:Organization
Organization Name:RAGHVENDRA P SINGH DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAGHVENDRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-739-6800
Mailing Address - Street 1:7557 MORNING BROOK DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-2507
Mailing Address - Country:US
Mailing Address - Phone:702-739-6800
Mailing Address - Fax:702-739-7800
Practice Address - Street 1:7557 MORNING BROOK DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-2507
Practice Address - Country:US
Practice Address - Phone:702-739-6800
Practice Address - Fax:702-739-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV36832Medicare ID - Type UnspecifiedMEDICARE GROUP ID