Provider Demographics
NPI:1295758241
Name:WADHWANI, DAVID(DEEPAK) LAL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID(DEEPAK)
Middle Name:LAL
Last Name:WADHWANI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11600 INDIAN HILLS RD
Mailing Address - Street 2:#200
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1225
Mailing Address - Country:US
Mailing Address - Phone:818-838-4500
Mailing Address - Fax:818-838-7570
Practice Address - Street 1:11600 INDIAN HILLS RD
Practice Address - Street 2:#200
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1225
Practice Address - Country:US
Practice Address - Phone:818-838-4500
Practice Address - Fax:818-838-7570
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-11-06
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Provider Licenses
StateLicense IDTaxonomies
CAA74762207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH48722Medicare UPIN