Healthcare Provider Details

I. General information

NPI: 1184917700
Provider Name (Legal Business Name): MONA GIRISH MEHTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13640 N 99TH AVE STE 100
SUN CITY AZ
85351-0001
US

IV. Provider business mailing address

13640 N 99TH AVE STE 100
SUN CITY AZ
85351-0001
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-5700
  • Fax: 623-328-9181
Mailing address:
  • Phone: 623-322-5700
  • Fax: 623-328-9181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number281232
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: