Provider Demographics
NPI:1194134239
Name:RAVI RAJ SINGH MD, INC
Entity type:Organization
Organization Name:RAVI RAJ SINGH MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:RAJ
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-767-8811
Mailing Address - Street 1:8730 GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2801
Mailing Address - Country:US
Mailing Address - Phone:818-767-8811
Mailing Address - Fax:818-767-8813
Practice Address - Street 1:8730 GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2801
Practice Address - Country:US
Practice Address - Phone:818-767-8811
Practice Address - Fax:818-767-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-02
Last Update Date:2014-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127484207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA127484OtherMEDICAL LICENSE