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General NPI Number Information
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NPI Number | 1114949492
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Entity Type | Individual
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Provider Name | JALDEEP H DAULAT DO
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 3975 S DURANGO DR STE 107
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City | LAS VEGAS
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State | NV
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Zip | 89147-4156
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Country | US
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Telephone | 702-628-5333
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Fax | 702-974-0440
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Provider Business Mailing Address
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Address Line | 9750 W SKYE CANYON PARK DR SUITE 160 BOX 103
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City | LAS VEGAS
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State | NV
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Zip | 89166
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Country | US
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Telephone | 702-683-1727
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Fax | 702-974-0440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 363
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License Number State | NV
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