Provider Demographics
NPI:1306985767
Name:DECCAN PACIFIC MEDICAL GROUP, PC
Entity type:Organization
Organization Name:DECCAN PACIFIC MEDICAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:CHANDER
Authorized Official - Last Name:KARIPINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-284-4100
Mailing Address - Street 1:1860 MOWRY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1730
Mailing Address - Country:US
Mailing Address - Phone:510-284-4100
Mailing Address - Fax:510-794-9783
Practice Address - Street 1:1860 MOWRY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1730
Practice Address - Country:US
Practice Address - Phone:510-284-4100
Practice Address - Fax:510-794-9783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Not Answered2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21948ZMedicare ID - Type Unspecified