Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 10615 | CA |
NPI | 1114325180 |
---|---|
Provider Name | Randeep Singh |
First Address | Ceres, CA 95307-7130 |
Second Address | Ceres, CA 95307-7130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2014 |
Last Update Date | 08/12/2014 |