Provider Demographics
NPI:1568868065
Name:NEIL D DALAL, MD, INC
Entity Type:Organization
Organization Name:NEIL D DALAL, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DALAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-942-6577
Mailing Address - Street 1:833 AUTO CENTER DR
Mailing Address - Street 2:STE D AND E
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4488
Mailing Address - Country:US
Mailing Address - Phone:661-942-6577
Mailing Address - Fax:
Practice Address - Street 1:833 AUTO CENTER DR
Practice Address - Street 2:STE D AND E
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4488
Practice Address - Country:US
Practice Address - Phone:661-942-6577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1301272086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty