Healthcare Provider Details

I. General information

NPI: 1083225098
Provider Name (Legal Business Name): MANJINDER SINGH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 HIGHWAY 99 UNIT A
GRIDLEY CA
95948-2615
US

IV. Provider business mailing address

1653 HIGHWAY 99 UNIT A
GRIDLEY CA
95948-2615
US

V. Phone/Fax

Practice location:
  • Phone: 530-456-6449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number82998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: