=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912493107
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TULASI DEEPTHI KARRI MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2018
-----------------------------------------------------
Last Update Date | 10/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 S MAIN ST STE 160
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92868-4500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-509-3444
-----------------------------------------------------
Fax | 714-509-3477
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 S MAIN ST STE 160
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92868-4500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-509-3444
-----------------------------------------------------
Fax | 714-509-3477
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 4301115516
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 4301504070
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------