Provider Demographics
NPI:1346343985
Name:DALAL, RUPAL MANISH (MD)
Entity Type:Individual
Prefix:DR
First Name:RUPAL
Middle Name:MANISH
Last Name:DALAL
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 1:3273 VINEYARD PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-2066
Mailing Address - Country:US
Mailing Address - Phone:408-531-1676
Mailing Address - Fax:
Practice Address - Street 1:3273 VINEYARD PARKWAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-2066
Practice Address - Country:US
Practice Address - Phone:408-531-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA069705208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics