MEDICARE: DR. DEEPAL S SIDHU 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	207L00000X	Anesthesiology Physician	220323	MA
2	207L00000X	Anesthesiology Physician	C52294	CA
3	207L00000X	Anesthesiology Physician	MD227274	OR
4	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	220323	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	469452	OTHER	MA	TUFTS HEALTH PLAN
3	J27323	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1649246349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEPAL S SIDHU MD

Provider Business Mailing Address
First Line	:	3212 WHITESAND DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95148-3807
Country	:	US
Telephone Number	:	408-834-5175
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 HOSPITAL PKWY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1103
Country	:	US
Telephone Number	:	408-972-6320
Fax Number	:

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	01/02/2026

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Directions to “ DR. DEEPAL S SIDHU MD” Practice Location

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