Healthcare Provider Details

I. General information

NPI: 1942537840
Provider Name (Legal Business Name): SUKRANT MEHTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N ROXBURY DR STE 101
BEVERLY HILLS CA
90210-4209
US

IV. Provider business mailing address

9903 S SANTA MONICA BLVD PMB 208
BEVERLY HILLS CA
90212-1606
US

V. Phone/Fax

Practice location:
  • Phone: 310-299-0187
  • Fax: 310-579-4992
Mailing address:
  • Phone: 310-299-0187
  • Fax: 310-579-4992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA121074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: