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General NPI Number Information
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NPI Number | 1285961243
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Entity Type | Organization
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Legal Business Name | NALINI BHALLA MD PLLC
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 10238 E HAMPTON AVE SUITE 205
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City | MESA
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State | AZ
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Zip | 85209-3316
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Country | US
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Telephone | 602-499-1929
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Fax |
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Provider Business Mailing Address
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Address Line | 10238 E HAMPTON AVE SUITE 205
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City | MESA
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State | AZ
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Zip | 85209-3316
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Country | US
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Telephone | 602-499-1929
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. NALINI SRIDHAR BHALLA
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Credential | MD
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Telephone | 602-499-1929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30546
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License Number State | AZ
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