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NPI Code Detail

MEDICARE: MR. DEEPAK K SHRIVASTAVA MD

MEDICARE: MR. DEEPAK K SHRIVASTAVA 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
1207RP1001XPulmonary Disease PhysicianA4577CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841267317
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEEPAK K SHRIVASTAVA MD
Provider Business Mailing Address
First Line : PO BOX 986
Second Line :
City : WOODBRIDGE
State : CA
Zip : 95258-0986
Country : US
Telephone Number : 209-339-9036
Fax Number : 209-339-1901
Provider Business Practice Location Address
First Line : 500 W HOSPITAL RD
Second Line :
City : FRENCH CAMP
State : CA
Zip : 95231-9693
Country : US
Telephone Number : 209-468-6820
Fax Number : 209-468-6103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 10/26/2020

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