Healthcare Provider Details

I. General information

NPI: 1932841871
Provider Name (Legal Business Name): RAJAN SINGH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4302 ALTON RD STE 510
MIAMI BEACH FL
33140-2842
US

IV. Provider business mailing address

5425 PORT ALICE WAY
SALIDA CA
95368-9637
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2667
  • Fax:
Mailing address:
  • Phone: 209-380-8137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE6148
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE6148
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: