Provider Demographics
NPI:1730361544
Name:SINGH, JHUJHAR (DO)
Entity type:Individual
Prefix:MR
First Name:JHUJHAR
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4959 PALO VERDE ST
Mailing Address - Street 2:STE 206A-5
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2342
Mailing Address - Country:US
Mailing Address - Phone:909-694-4016
Mailing Address - Fax:909-920-3344
Practice Address - Street 1:4959 PALO VERDE ST
Practice Address - Street 2:STE 206A-5
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2342
Practice Address - Country:US
Practice Address - Phone:909-694-4016
Practice Address - Fax:909-920-3344
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10159208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFD077AMedicare UPIN