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General NPI Number Information
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NPI Number | 1992733323
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Entity Type | Individual
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Provider Name | DEEPAK V SHETH MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 360 E 7TH ST #C
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-920-9800
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Fax | 909-931-0515
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Provider Business Mailing Address
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Address Line | 2058 N MILLS AVE PMB #445
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City | CLAREMONT
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State | CA
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Zip | 91711
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Country | US
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Telephone | 909-920-9800
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Fax | 909-931-0515
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A43876
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License Number State | CA
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