Healthcare Provider Details

I. General information

NPI: 1184278798
Provider Name (Legal Business Name): GAGAN DEEP SINGH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3090 M ST STE 9
MERCED CA
95348-3212
US

IV. Provider business mailing address

PO BOX 3018
SANTA CLARA CA
95055-3018
US

V. Phone/Fax

Practice location:
  • Phone: 209-580-4136
  • Fax:
Mailing address:
  • Phone: 408-540-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HARSIMRAT KAUR BAINS
Title or Position: OFFICE MANAGER
Credential:
Phone: 408-540-3166