MEDICARE: DR. DEEPA CHITRE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A46087	CA

General Provider Information

NPI Number	:	1427750785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEPA CHITRE MD

Provider Business Mailing Address
First Line	:	1929 OTOOLE WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2238
Country	:	US
Telephone Number	:	408-768-7464
Fax Number	:	408-432-4027

Provider Business Practice Location Address
First Line	:	1929 OTOOLE WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2238
Country	:	US
Telephone Number	:	408-768-7464
Fax Number	:	408-432-4027

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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