Provider Demographics
NPI:1730523499
Name:SINGH, NATHAN GLEN (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:GLEN
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2160 APPIAN WAY STE 220
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2576
Mailing Address - Country:US
Mailing Address - Phone:510-724-1306
Mailing Address - Fax:530-541-5738
Practice Address - Street 1:2160 APPIAN WAY STE 220
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2576
Practice Address - Country:US
Practice Address - Phone:510-724-1306
Practice Address - Fax:530-541-5738
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA137308207QS0010X, 207Q00000X
CA137308207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty