Provider Demographics
NPI:1962486332
Name:SINGER, MARK STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:STEPHEN
Last Name:SINGER
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 1:3334 STERLING CT
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-4262
Mailing Address - Country:US
Mailing Address - Phone:707-365-5151
Mailing Address - Fax:707-252-4887
Practice Address - Street 1:3334 STERLING CT
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-4262
Practice Address - Country:US
Practice Address - Phone:707-365-5151
Practice Address - Fax:707-252-4887
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAG539243207P00000X
CAG53924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACAG539243OtherSTATE LICENSE
CAA52624Medicare UPIN