Provider Demographics
NPI:1003891169
Name:DEEPIKA WALI, M.D., INC.
Entity Type:Organization
Organization Name:DEEPIKA WALI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-783-9990
Mailing Address - Street 1:PO BOX 2150
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93258-2150
Mailing Address - Country:US
Mailing Address - Phone:559-783-9990
Mailing Address - Fax:559-783-9991
Practice Address - Street 1:774 N PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-1941
Practice Address - Country:US
Practice Address - Phone:559-783-9990
Practice Address - Fax:559-783-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty