Provider Demographics
NPI:1992733323
Name:SHETH, DEEPAK V (MD)
Entity type:Individual
Prefix:
First Name:DEEPAK
Middle Name:V
Last Name:SHETH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2058 N MILLS AVE
Mailing Address - Street 2:PMB #445
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711
Mailing Address - Country:US
Mailing Address - Phone:909-920-9800
Mailing Address - Fax:909-931-0515
Practice Address - Street 1:360 E 7TH ST
Practice Address - Street 2:#C
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786
Practice Address - Country:US
Practice Address - Phone:909-920-9800
Practice Address - Fax:909-931-0515
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2011-11-30
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Provider Licenses
StateLicense IDTaxonomies
CAA43876208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E25108Medicare UPIN
CA00A438760Medicare ID - Type Unspecified