Provider Demographics
NPI:1811178981
Name:AJEET R SINGHVI
Entity type:Organization
Organization Name:AJEET R SINGHVI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AJEET
Authorized Official - Middle Name:R
Authorized Official - Last Name:SINGHVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-929-0124
Mailing Address - Street 1:397 N SAN JACINTO ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3118
Mailing Address - Country:US
Mailing Address - Phone:951-929-0124
Mailing Address - Fax:951-929-4567
Practice Address - Street 1:397 N SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3118
Practice Address - Country:US
Practice Address - Phone:951-929-0124
Practice Address - Fax:951-929-4567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA370930261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASUR01371FMedicaid
CAZZZ13587ZMedicare PIN