Provider Demographics
NPI:1790963726
Name:KANCHERLA, DEEPIKA (MD)
Entity Type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:
Last Name:KANCHERLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2485 HIGH SCHOOL AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1814
Mailing Address - Country:US
Mailing Address - Phone:925-687-7272
Mailing Address - Fax:925-687-1847
Practice Address - Street 1:2485 HIGH SCHOOL AVE STE 311
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1814
Practice Address - Country:US
Practice Address - Phone:925-687-7272
Practice Address - Fax:925-687-1847
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
282N00000X
CAA102562207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No282N00000XHospitalsGeneral Acute Care Hospital