Healthcare Provider Details

I. General information

NPI: 1114273729
Provider Name (Legal Business Name): ANAND MEHTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5170 GOLDEN FOOTHILL PKWY
EL DORADO HILLS CA
95762-9608
US

IV. Provider business mailing address

5170 GOLDEN FOOTHILL PKWY
EL DORADO HILLS CA
95762-9608
US

V. Phone/Fax

Practice location:
  • Phone: 916-629-4443
  • Fax: 916-778-5762
Mailing address:
  • Phone: 916-629-4443
  • Fax: 916-778-5762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA133776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: