Provider Demographics
NPI:1457360901
Name:SINGEL, SOREN A (MD)
Entity Type:Individual
Prefix:
First Name:SOREN
Middle Name:A
Last Name:SINGEL
Suffix:
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 1:555 BRYANT ST
Mailing Address - Street 2:STE 909
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1704
Mailing Address - Country:US
Mailing Address - Phone:650-257-2976
Mailing Address - Fax:650-257-2979
Practice Address - Street 1:125 N JACKSON AVE STE 107
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1915
Practice Address - Country:US
Practice Address - Phone:650-257-2976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8349207T00000X, 2085N0700X
CA72823207T00000X
OH35.086313207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I46620Medicare UPIN
G8857421Medicare PIN
I46620Medicare UPIN
G8857421Medicare PIN