Individual
MR. DEEPAK K SHRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W HOSPITAL RD, FRENCH CAMP, CA 95231-9693
(209) 468-6820
(209) 468-6103
Mailing address
PO BOX 986, WOODBRIDGE, CA 95258-0986
(209) 339-9036
(209) 339-1901
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A4577
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A457702
—
CA
Enumeration date
03/03/2006
Last updated
10/26/2020
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