Provider Demographics
NPI:1396373130
Name:PITHADIA, DEETI J (MD)
Entity Type:Individual
Prefix:
First Name:DEETI
Middle Name:J
Last Name:PITHADIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 BROADWAY, PAVILION C, 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063
Mailing Address - Country:US
Mailing Address - Phone:650-723-6316
Mailing Address - Fax:
Practice Address - Street 1:450 BROADWAY, PAVILION C, 2ND FLOOR
Practice Address - Street 2:PAVILION B, 4TH FLOOR
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063
Practice Address - Country:US
Practice Address - Phone:650-723-6316
Practice Address - Fax:650-721-3476
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program