Healthcare Provider Details

I. General information

NPI: 1124213178
Provider Name (Legal Business Name): DEEPTI SINHA M.D., FRACP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEEPTI SRIVASTAVA M.D.

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 EL CAMINO REAL STE 105
BURLINGAME CA
94010-3224
US

IV. Provider business mailing address

1720 EL CAMINO REAL STE 150
BURLINGAME CA
94010-3231
US

V. Phone/Fax

Practice location:
  • Phone: 650-779-4055
  • Fax: 650-777-9111
Mailing address:
  • Phone: 650-697-7079
  • Fax: 650-697-5845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberA104240
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA104240
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberA104240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: