MEDICARE: DR. MINESH MEHTA M.D., C.C.F.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A062994	CA

General Provider Information

NPI Number	:	1710923750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MINESH MEHTA M.D., C.C.F.P.

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-579-3203
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 E CARSON ST
Second Line	:	SUITE 104
City	:	CARSON
State	:	CA
Zip	:	90745-2262
Country	:	US
Telephone Number	:	310-793-3520
Fax Number	:	310-830-6621

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	01/18/2026

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