Healthcare Provider Details

I. General information

NPI: 1073842852
Provider Name (Legal Business Name): AKSHAY MEHTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 07/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4305 TORRANCE BLVD 109
TORRANCE CA
90503-4421
US

IV. Provider business mailing address

4305 TORRANCE BLVD 109
TORRANCE CA
90503-4421
US

V. Phone/Fax

Practice location:
  • Phone: 310-406-3900
  • Fax: 310-406-3902
Mailing address:
  • Phone: 310-406-3900
  • Fax: 310-406-3902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA113544
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA113544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: