Provider Demographics
NPI:1700292927
Name:MANMEET SINGH PADDA MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MANMEET SINGH PADDA MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MANMEET
Authorized Official - Middle Name:S
Authorized Official - Last Name:PADDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-256-3637
Mailing Address - Street 1:3022 S DURANGO DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4439
Mailing Address - Country:US
Mailing Address - Phone:702-256-3637
Mailing Address - Fax:
Practice Address - Street 1:32483 TEMECULA PKWY
Practice Address - Street 2:SUITE 112, PMB #48
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-9619
Practice Address - Country:US
Practice Address - Phone:702-256-3637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85290207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty