Provider Demographics
NPI:1972560605
Name:SINGH, RAVINDER P (MD)
Entity Type:Individual
Prefix:MRS
First Name:RAVINDER
Middle Name:P
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:12555 GARDEN GROVE BLVD
Mailing Address - Street 2:# 305
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1902
Mailing Address - Country:US
Mailing Address - Phone:714-537-7722
Mailing Address - Fax:714-537-7733
Practice Address - Street 1:12555 GARDEN GROVE BLVD
Practice Address - Street 2:#305
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1902
Practice Address - Country:US
Practice Address - Phone:714-537-7722
Practice Address - Fax:714-537-7733
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA300402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A300400Medicaid
CAA30040AMedicare ID - Type Unspecified
CA00A300400Medicaid