Provider Demographics
NPI:1255639506
Name:J.SINGH D.O.,INC
Entity type:Organization
Organization Name:J.SINGH D.O.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JHUJHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-694-4016
Mailing Address - Street 1:4959 PALO VERDE ST
Mailing Address - Street 2:SUITE 206A-5
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2331
Mailing Address - Country:US
Mailing Address - Phone:909-694-4016
Mailing Address - Fax:909-920-3344
Practice Address - Street 1:4959 PALO VERDE ST
Practice Address - Street 2:SUITE 206A-5
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2331
Practice Address - Country:US
Practice Address - Phone:909-694-4016
Practice Address - Fax:909-920-3344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10159208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX101590Medicaid
CA020A101590Medicare PIN
CAAR799ZMedicare PIN