Provider Demographics
NPI:1255884672
Name:VELLAICHAMY MANIAN, DEEPTI (MD)
Entity type:Individual
Prefix:
First Name:DEEPTI
Middle Name:
Last Name:VELLAICHAMY MANIAN
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 1:270 INTERNATIONAL CIR BLDG 31
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1100
Mailing Address - Country:US
Mailing Address - Phone:408-363-4597
Mailing Address - Fax:
Practice Address - Street 1:270 INTERNATIONAL CIR BLDG 31
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1100
Practice Address - Country:US
Practice Address - Phone:408-363-4597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-44754207K00000X
CAA201753207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology