Provider Demographics
NPI:1306904727
Name:SINGH, VIKRAM JEET (MD)
Entity type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:JEET
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 1:6640 VAN NUYS BLVD. SUITE #101
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405
Mailing Address - Country:US
Mailing Address - Phone:818-884-5480
Mailing Address - Fax:818-884-5490
Practice Address - Street 1:6640 VAN NUYS BLVD. SUITE #101
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-884-5480
Practice Address - Fax:818-884-5490
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42285174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42285CMedicare PIN