Healthcare Provider Details

I. General information

NPI: 1861294902
Provider Name (Legal Business Name): JIVTESHWAR SINGH RRT, RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOE SINGH

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 INTERNATIONAL CIR
SAN JOSE CA
95119-1130
US

IV. Provider business mailing address

221 DE BORD DR
TRACY CA
95376-7002
US

V. Phone/Fax

Practice location:
  • Phone: 408-363-4827
  • Fax:
Mailing address:
  • Phone: 209-740-5655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number32115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: