Provider Demographics
NPI:1285812990
Name:DILIP D. MADNANI, M.D., LLC
Entity type:Organization
Organization Name:DILIP D. MADNANI, M.D., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DILIP
Authorized Official - Middle Name:D
Authorized Official - Last Name:MADNANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-887-9528
Mailing Address - Street 1:2402 W PIERCE ST
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3537
Mailing Address - Country:US
Mailing Address - Phone:575-887-9528
Mailing Address - Fax:
Practice Address - Street 1:2402 W PIERCE ST
Practice Address - Street 2:SUITE 3C
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3537
Practice Address - Country:US
Practice Address - Phone:575-887-9528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2006-0201207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty