Individual
DEEPTI SAMEER MUNDKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
211 13TH ST, RAMONA, CA 92065-2711
(760) 789-5160
Mailing address
15611 POMERADO RD STE 400, POWAY, CA 92064-2437
(858) 675-3100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A158230
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A158230
CA MED LICENSE
CA
Enumeration date
04/02/2016
Last updated
07/30/2019
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