Basic Information
Provider Information
NPI: 1780888958
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: AMARDEEP
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3400 DATA DR
Address2: PHYSICIAN SUPPORT SERVICES
City: RANCHO CORDOVA
State: CA
PostalCode: 956707956
CountryCode: US
TelephoneNumber: 9163792948
FaxNumber: 9168587065
Practice Location
Address1: 6555 COYLE AVE
Address2:  
City: CARMICHAEL
State: CA
PostalCode: 956080302
CountryCode: US
TelephoneNumber: 9165363560
FaxNumber: 9165363567
Other Information
ProviderEnumerationDate: 06/12/2007
LastUpdateDate: 12/31/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0011XA97949CAY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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