Provider Demographics
NPI:1164927257
Name:DALAL, DEEPAL HARISH (DPM, MS)
Entity Type:Individual
Prefix:DR
First Name:DEEPAL
Middle Name:HARISH
Last Name:DALAL
Suffix:
Gender:F
Credentials:DPM, MS
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Mailing Address - Street 1:191 S BUENA VISTA ST STE 235
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4563
Mailing Address - Country:US
Mailing Address - Phone:818-980-9393
Mailing Address - Fax:818-524-2807
Practice Address - Street 1:191 S BUENA VISTA ST STE 235
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4563
Practice Address - Country:US
Practice Address - Phone:818-980-9393
Practice Address - Fax:818-524-2807
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5739213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery