Provider Demographics
NPI:1154618932
Name:SINGH, RAHUL KUMAR (OD)
Entity type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:KUMAR
Last Name:SINGH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 722
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95038-0722
Mailing Address - Country:US
Mailing Address - Phone:408-710-6423
Mailing Address - Fax:
Practice Address - Street 1:2662 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1533
Practice Address - Country:US
Practice Address - Phone:650-366-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14135T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01034368Medicare PIN
CAFH516AMedicare PIN