Provider Demographics
NPI:1932106382
Name:MUKESH AMIN MD & TEJINDER SINGH MD INC
Entity Type:Organization
Organization Name:MUKESH AMIN MD & TEJINDER SINGH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUKESH
Authorized Official - Middle Name:S
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-985-2872
Mailing Address - Street 1:914 W FOOTHILL BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3785
Mailing Address - Country:US
Mailing Address - Phone:909-985-2872
Mailing Address - Fax:909-985-0932
Practice Address - Street 1:914 W FOOTHILL BLVD
Practice Address - Street 2:STE B
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3785
Practice Address - Country:US
Practice Address - Phone:909-985-2872
Practice Address - Fax:909-985-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0071810Medicaid
CAZZZ13435ZMedicare ID - Type Unspecified
CAW14402Medicare ID - Type Unspecified
CAGR0071810Medicaid