Provider Demographics
NPI:1316625270
Name:SINGH BASRA, DALWINDER (MD)
Entity type:Individual
Prefix:MR
First Name:DALWINDER
Middle Name:
Last Name:SINGH BASRA
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 1:43 MARNE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312
Mailing Address - Country:US
Mailing Address - Phone:647-533-3754
Mailing Address - Fax:
Practice Address - Street 1:1800 N. CALIFORNIA ST.
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204
Practice Address - Country:US
Practice Address - Phone:209-547-7146
Practice Address - Fax:209-547-7197
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program