Healthcare Provider Details

I. General information

NPI: 1942886379
Provider Name (Legal Business Name): JOSEPH NATHANIEL MEHRABI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 INDIAN HILLS RD
MISSION HILLS CA
91345-1225
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 818-838-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA194640
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: