MEDICARE: DR. DEEPIKA GARG O.D.

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	152W00000X	Optometrist	OPT34776-TLG	CA

General Provider Information

NPI Number	:	1740631159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEPIKA GARG O.D.

Provider Business Mailing Address
First Line	:	433 MAVIS DR
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94566-6809
Country	:	US
Telephone Number	:	317-702-4854
Fax Number	:

Provider Business Practice Location Address
First Line	:	5503 LEESBURG PIKE
Second Line	:
City	:	BAILEYS CROSSROADS
State	:	VA
Zip	:	22041-3109
Country	:	US
Telephone Number	:	317-702-4854
Fax Number	:

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

Provider Enumeration Date	:	06/27/2016
Last Update Date	:	05/14/2025

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