Healthcare Provider Details

I. General information

NPI: 1801437405
Provider Name (Legal Business Name): PRECISIONE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

700 GARDEN VIEW COURT SUITE 200
ENCINITAS CA
92024-2478
US

IV. Provider business mailing address

2804 GATEWAY OAKS DRIVE #100
SACRAMENTO CA
95833-4346
US

V. Phone/Fax

Practice location:
  • Phone: 703-869-0100
  • Fax:
Mailing address:
  • Phone: 703-869-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MARVIN MOHAN SINGH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D.
Phone: 703-869-0100