Basic Information
Provider Information
NPI: 1679507248
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: VINITA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18000 STUDEBAKER RD STE 800
Address2:  
City: CERRITOS
State: CA
PostalCode: 907032671
CountryCode: US
TelephoneNumber: 5627353226
FaxNumber:  
Practice Location
Address1: 18433 ROSCOE BLVD STE 106
Address2:  
City: NORTHRIDGE
State: CA
PostalCode: 91325
CountryCode: US
TelephoneNumber: 8184358819
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 12/11/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XC138183CAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
0214845605NY MEDICAID


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