Provider Demographics
NPI:1194780999
Name:SINGH, GURPREET (MD)
Entity type:Individual
Prefix:DR
First Name:GURPREET
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 1:4120 DALE RD
Mailing Address - Street 2:SUITE J8-240
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9232
Mailing Address - Country:US
Mailing Address - Phone:209-485-6400
Mailing Address - Fax:
Practice Address - Street 1:981 E TUOLUMNE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1544
Practice Address - Country:US
Practice Address - Phone:209-656-6800
Practice Address - Fax:209-656-6828
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102350207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0098434Medicaid
NJ0098434Medicaid