Healthcare Provider Details

I. General information

NPI: 1689202343
Provider Name (Legal Business Name): DEEPESH KUMAR YADAV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MOWRY AVE STE 220
FREMONT CA
94538-1626
US

IV. Provider business mailing address

2333 MOWRY AVE STE 300
FREMONT CA
94538-1626
US

V. Phone/Fax

Practice location:
  • Phone: 510-894-2236
  • Fax: 510-792-7986
Mailing address:
  • Phone: 510-796-0222
  • Fax: 510-796-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA204078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: