Basic Information
| Provider Information | |||||||||
| NPI: | 1194780999 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGH | ||||||||
| FirstName: | GURPREET | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4120 DALE RD | ||||||||
| Address2: | SUITE J8-240 | ||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953569232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2094856400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 981 E TUOLUMNE RD | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | TURLOCK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953821544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2096566800 | ||||||||
| FaxNumber: | 2096566828 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2006 | ||||||||
| LastUpdateDate: | 03/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | A102350 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207R00000X | A102350 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0098434 | 05 | NJ | MEDICAID |