Healthcare Provider Details

I. General information

NPI: 1932669876
Provider Name (Legal Business Name): CHANDAN SINGH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HAMPDEN AVE
ENGLEWOOD CO
80113-2702
US

IV. Provider business mailing address

2755 PARK PL
GRAND PRAIRIE TX
75052-8583
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-5000
  • Fax:
Mailing address:
  • Phone: 816-665-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number56651
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA192609
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0006290
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: