Healthcare Provider Details

I. General information

NPI: 1174895882
Provider Name (Legal Business Name): DEEPA MAHESWARI NARASIMHULU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 LOMA VISTA RD STE 205
VENTURA CA
93003-2909
US

IV. Provider business mailing address

5855 OLIVAS PARK DR
VENTURA CA
93003-7672
US

V. Phone/Fax

Practice location:
  • Phone: 805-642-4830
  • Fax:
Mailing address:
  • Phone: 805-667-2801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number64432
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number282192
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA175124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: