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NPI Code Detail

MEDICARE: SHANTI TEPPARA MD

MEDICARE: SHANTI TEPPARA 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1578401790
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANTI TEPPARA MD
Provider Business Mailing Address
First Line : 215 W JANSS RD
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-1847
Country : US
Telephone Number : 805-852-9229
Fax Number :
Provider Business Practice Location Address
First Line : 215 W JANSS RD
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-1847
Country : US
Telephone Number : 805-852-9229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ SHANTI TEPPARA MD” Practice Location

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