Shivaram, Deepak A
Shivaram, Deepak A is an sole proprietor health care provider with primary practice located at 44215 15Th St W Ste 111 , Lancaster CA 93534-5503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Shivaram, Deepak A can be contacted via phone (661) 949-5941.Contact Information
Primary practice address
44215 15Th St W Ste 111
Lancaster CA 93534-5503
Phone: (661) 949-5941
Fax: (661) 949-5871
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A62177 | California |
Profile Details
| NPI number | 1588655450 |
|---|---|
| LBN Legal business name | Shivaram, Deepak A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Feb 26th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588655450 | NPPES |
| California | MEDICAID | 00A621770 | |
| California | Other | 331042573 |
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