Provider Demographics
NPI:1104820729
Name:SINGH, TEJINDER (MD)
Entity type:Individual
Prefix:
First Name:TEJINDER
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 W FOOTHILL BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3785
Mailing Address - Country:US
Mailing Address - Phone:909-982-8944
Mailing Address - Fax:909-985-0932
Practice Address - Street 1:914 W FOOTHILL BLVD
Practice Address - Street 2:STE B
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3785
Practice Address - Country:US
Practice Address - Phone:909-982-8944
Practice Address - Fax:909-985-0932
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41265207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A412650Medicaid
CA00A412650Medicaid
A29340Medicare UPIN
00A412650Medicare ID - Type UnspecifiedSB CTY