Provider Demographics
NPI:1194102632
Name:SINGH, INDIRA RANI (MD)
Entity type:Individual
Prefix:
First Name:INDIRA
Middle Name:RANI
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14251 WINCHESTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1811
Mailing Address - Country:US
Mailing Address - Phone:408-426-5540
Mailing Address - Fax:
Practice Address - Street 1:14251 WINCHESTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1811
Practice Address - Country:US
Practice Address - Phone:408-426-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA149510207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIS3232267556Medicaid