Provider Demographics
NPI:1598116857
Name:GARG, DEEPAK
Entity Type:Individual
Prefix:
First Name:DEEPAK
Middle Name:
Last Name:GARG
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:DEEPAK
Other - Middle Name:
Other - Last Name:GARG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11234 ANDERSON ST # MC-1516
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:517-788-4800
Mailing Address - Fax:517-817-7050
Practice Address - Street 1:11234 ANDERSON ST # MC-1516
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-4884
Practice Address - Fax:909-558-0428
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61965208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist