Healthcare Provider Details

I. General information

NPI: 1306427927
Provider Name (Legal Business Name): SUKHDEV SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 UNIVERSITY AVE
RIVERSIDE CA
92521-7107
US

IV. Provider business mailing address

6038 E SINCLAIR ST
PHOENIX AZ
85054-5791
US

V. Phone/Fax

Practice location:
  • Phone: 909-475-2612
  • Fax: 909-475-5059
Mailing address:
  • Phone: 310-961-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA195883
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number80510
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: