Healthcare Provider Details

I. General information

NPI: 1154965267
Provider Name (Legal Business Name): SAHIB SINGH ND, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 10/26/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 N LITCHFIELD RD STE 120
GOODYEAR AZ
85395-7803
US

IV. Provider business mailing address

8250 N VIA PASEO DEL NORTE APT E207
SCOTTSDALE AZ
85258-3717
US

V. Phone/Fax

Practice location:
  • Phone: 480-720-4782
  • Fax:
Mailing address:
  • Phone: 480-779-8188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number010137
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number20-1888
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: