Individual
MRS. DEEPA KANNADITHARAYIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 550-4785
(209) 550-4888
Mailing address
10470 OLD PLACERVILLE RD STE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A143758
CA
Other
Enumeration date
11/18/2009
Last updated
09/09/2019
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