Healthcare Provider Details

I. General information

NPI: 1568842086
Provider Name (Legal Business Name): KULDEEP SINGH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27509 AGOURA RD STE 110
AGOURA HILLS CA
91301-5152
US

IV. Provider business mailing address

27509 AGOURA RD STE 110
AGOURA HILLS CA
91301-5152
US

V. Phone/Fax

Practice location:
  • Phone: 833-477-8578
  • Fax:
Mailing address:
  • Phone: 833-477-8578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number60904
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number20A18846
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number103935
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: