Healthcare Provider Details

I. General information

NPI: 1093081499
Provider Name (Legal Business Name): SINGH MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E WHEELER RD
MOSES LAKE WA
98837-1820
US

IV. Provider business mailing address

6440 SKY POINTE DR SUITE 140-143
LAS VEGAS NV
89131-4047
US

V. Phone/Fax

Practice location:
  • Phone: 509-765-5606
  • Fax:
Mailing address:
  • Phone: 702-453-3799
  • Fax: 702-453-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD60025833
License Number StateWA

VIII. Authorized Official

Name: LORI LABRECQUE
Title or Position: ACCTS. MGR
Credential:
Phone: 702-453-3799