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General NPI Number Information
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NPI Number | 1902354509
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Entity Type | Organization
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Legal Business Name | DEEP MEDICAL CLINIC, INC
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 29839 SANTA MARGARITA PKWY STE 100
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-3616
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Country | US
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Telephone | 949-577-3937
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Fax | 949-209-4182
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Provider Business Mailing Address
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Address Line | 124 COYOTE BRUSH
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City | IRVINE
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State | CA
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Zip | 92618-8873
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Country | US
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Telephone | 949-701-2526
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Fax | 949-209-4182
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. DEEPAK R PATEL
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Credential | M.D.
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Telephone | 949-701-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C140704
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License Number State | CA
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