Provider Demographics
NPI:1700088036
Name:SINGH, MATAB (MD)
Entity Type:Individual
Prefix:DR
First Name:MATAB
Middle Name:
Last Name:SINGH
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 1:9338 TAMPA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2744
Mailing Address - Country:US
Mailing Address - Phone:818-408-9260
Mailing Address - Fax:
Practice Address - Street 1:5401 BUSINESS PARK DR. SUITE # 210 UNIT #6
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:818-408-9260
Practice Address - Fax:661-859-1209
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94862207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine