Provider Demographics
NPI:1427100973
Name:JAGJIT SINGH, M.D., INC
Entity type:Organization
Organization Name:JAGJIT SINGH, M.D., INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-943-0851
Mailing Address - Street 1:2350 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5506
Mailing Address - Country:US
Mailing Address - Phone:209-943-0851
Mailing Address - Fax:209-943-0137
Practice Address - Street 1:2350 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5506
Practice Address - Country:US
Practice Address - Phone:209-943-0851
Practice Address - Fax:209-943-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45075174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A450751Medicaid
CADH2397OtherRAILROAD MEDICARE
CA00A450750Medicaid
CAA29800Medicare UPIN
CA00A450751Medicare ID - Type Unspecified
CA00A450750Medicare ID - Type Unspecified
CAZZZ04130ZMedicare ID - Type UnspecifiedMEDICARE