Provider Demographics
NPI:1720248339
Name:NILESH H. HINGARH M.D., INC
Entity type:Organization
Organization Name:NILESH H. HINGARH M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NILESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HINGARH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-414-7677
Mailing Address - Street 1:PO BOX 803335
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-3335
Mailing Address - Country:US
Mailing Address - Phone:661-414-7677
Mailing Address - Fax:
Practice Address - Street 1:23861 MCBEAN PKWY
Practice Address - Street 2:E-26
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2058
Practice Address - Country:US
Practice Address - Phone:661-414-7677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80963207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A809630Medicaid
CAA80963Medicare PIN
CA00A809630Medicaid