Provider Demographics
NPI:1194809111
Name:GUPTA, NALINI (MBBS,DCH)
Entity type:Individual
Prefix:
First Name:NALINI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MBBS,DCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E SPOKANE FALLS BLVD # 1495
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2131
Mailing Address - Country:US
Mailing Address - Phone:509-990-5900
Mailing Address - Fax:509-606-2515
Practice Address - Street 1:310 N RIVERPOINT BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1610
Practice Address - Country:US
Practice Address - Phone:509-505-7481
Practice Address - Fax:509-606-2515
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050019208000000X
WAMD600952032080P0006X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics