Healthcare Provider Details

I. General information

NPI: 1417308693
Provider Name (Legal Business Name): DEEPTHI RIMMALAPUDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 DALE RD
MODESTO CA
95356-9718
US

IV. Provider business mailing address

4601 DALE RD
MODESTO CA
95356-9718
US

V. Phone/Fax

Practice location:
  • Phone: 209-921-1468
  • Fax:
Mailing address:
  • Phone: 209-921-1468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA162902
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: