Provider Demographics
NPI:1972558203
Name:SINGHA, MALWINDER S (MD)
Entity Type:Individual
Prefix:DR
First Name:MALWINDER
Middle Name:S
Last Name:SINGHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1515 N HARLEM AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1205
Mailing Address - Country:US
Mailing Address - Phone:401-575-0308
Mailing Address - Fax:
Practice Address - Street 1:8283 GROVE AVE STE 207A
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3141
Practice Address - Country:US
Practice Address - Phone:401-575-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA386402085R0204X
RIMD116732085R0204X
IL0361184822085R0204X
IN01061803A2085R0204X
WAMD000484322085R0204X
CAA928152085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INI50525Medicare UPIN