Healthcare Provider Details

I. General information

NPI: 1912638750
Provider Name (Legal Business Name): JATINDER PAUL SINGH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 GRANITO WAY
ROSEVILLE CA
95747-6977
US

IV. Provider business mailing address

1056 GRANITO WAY
ROSEVILLE CA
95747-6977
US

V. Phone/Fax

Practice location:
  • Phone: 713-992-7334
  • Fax:
Mailing address:
  • Phone: 713-992-7334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberOS22637
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: