Provider Demographics
NPI:1457812349
Name:SINGH, SHAM WEN (MD)
Entity Type:Individual
Prefix:
First Name:SHAM
Middle Name:WEN
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:924 3RD ST APT 203
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-2551
Mailing Address - Country:US
Mailing Address - Phone:510-673-8240
Mailing Address - Fax:
Practice Address - Street 1:811 W 7TH STREET
Practice Address - Street 2:SUITE 1200 OFFICE 1048
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3408
Practice Address - Country:US
Practice Address - Phone:310-430-7324
Practice Address - Fax:310-430-7324
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177716174400000X
CAA1777162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist