Provider Demographics
NPI:1205875606
Name:SINGH, TEJA JR (MD)
Entity type:Individual
Prefix:DR
First Name:TEJA
Middle Name:
Last Name:SINGH
Suffix:JR
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 1:2810 CAMINO DEL RIO S STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3819
Mailing Address - Country:US
Mailing Address - Phone:858-779-4686
Mailing Address - Fax:
Practice Address - Street 1:2810 CAMINO DEL RIO S STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3819
Practice Address - Country:US
Practice Address - Phone:858-779-4686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89960207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI50521Medicare UPIN
CAI50521Medicare UPIN