MEDICARE: DR. RICKY SINGH D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	50099	CA

General Provider Information

NPI Number	:	1922108505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICKY SINGH D.M.D

Provider Business Mailing Address
First Line	:	355 1ST ST
Second Line	:	APT# S-707
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94105-2692
Country	:	US
Telephone Number	:	267-738-3094
Fax Number	:

Provider Business Practice Location Address
First Line	:	914 THE ALAMEDA
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94707-2308
Country	:	US
Telephone Number	:	510-524-6234
Fax Number	:	510-524-7608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/08/2007

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