Healthcare Provider Details

I. General information

NPI: 1558553347
Provider Name (Legal Business Name): AMY K. MEHTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 SAN DIMAS ST BUILDING A SUITE 250
BAKERSFIELD CA
93301-2284
US

IV. Provider business mailing address

3838 SAN DIMAS ST BUILDING A SUITE 250
BAKERSFIELD CA
93301-2284
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-5300
  • Fax:
Mailing address:
  • Phone: 661-323-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA106378
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA106378
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: