Healthcare Provider Details

I. General information

NPI: 1013186907
Provider Name (Legal Business Name): SUDEEP SINGH M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7011 N HOWARD ST STE 201
FRESNO CA
93720-2955
US

IV. Provider business mailing address

8839 N CEDAR AVE # 53
FRESNO CA
93720-1832
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-9571
  • Fax: 559-431-4721
Mailing address:
  • Phone: 559-431-9589
  • Fax: 559-431-4721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number00A491470
License Number StateCA

VIII. Authorized Official

Name: DR. SUDEEP SINGH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 559-431-9589