Provider Demographics
NPI:1841249109
Name:SINGER, MARK IRWIN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:IRWIN
Last Name:SINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:723 CRESTMOORE PLACE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291
Mailing Address - Country:US
Mailing Address - Phone:415-328-8787
Mailing Address - Fax:916-854-6854
Practice Address - Street 1:723 CRESTMOORE PLACE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291
Practice Address - Country:US
Practice Address - Phone:415-328-8787
Practice Address - Fax:916-854-6854
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70069207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0G7006900Medicaid
CA0G7006900Medicare PIN
CA0G7006900Medicaid