Healthcare Provider Details

I. General information

NPI: 1689089625
Provider Name (Legal Business Name): MANTINDERPREET SINGH MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2014
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 NW 11TH ST STE M-013
HERMISTON OR
97838-6941
US

IV. Provider business mailing address

620 NW 11TH ST STE M-013
HERMISTON OR
97838-6941
US

V. Phone/Fax

Practice location:
  • Phone: 541-667-3883
  • Fax: 458-219-3078
Mailing address:
  • Phone: 541-667-3883
  • Fax: 458-219-3078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD226343
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: