Individual
DEEPENDRA MAHATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3353
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3353
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
20A12292
CA
Other
Enumeration date
11/01/2011
Last updated
03/09/2017
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