Provider Demographics
NPI:1275591000
Name:SINGH, RANDHIR H (MD)
Entity Type:Individual
Prefix:
First Name:RANDHIR
Middle Name:H
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 N CALIFORNIA ST STE 409
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-6033
Mailing Address - Country:US
Mailing Address - Phone:209-476-0900
Mailing Address - Fax:209-476-0909
Practice Address - Street 1:1805 N CALIFORNIA ST STE 409
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6033
Practice Address - Country:US
Practice Address - Phone:209-476-0900
Practice Address - Fax:209-476-0909
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30530171100000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A305300Medicaid
CA00A305301Medicare ID - Type UnspecifiedMEDICARE NUMBER
CA00A305300Medicaid