Healthcare Provider Details

I. General information

NPI: 1255592721
Provider Name (Legal Business Name): NEAL MEHRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 05/11/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 J ST
SACRAMENTO CA
95811-3010
US

IV. Provider business mailing address

5150 FAIR OAKS BLVD STE 101-321
CARMICHAEL CA
95608-5758
US

V. Phone/Fax

Practice location:
  • Phone: 916-737-5555
  • Fax:
Mailing address:
  • Phone: 916-936-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA95686
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA95686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: