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General NPI Number Information
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NPI Number | 1043673684
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Entity Type | Individual
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Provider Name | VIKRAM MEHTA M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2016
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Last Update Date | 09/23/2023
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Provider Practice Location Address
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Address Line | 1 HOAG DR
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4162
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Country | US
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Telephone | 949-764-4624
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Fax |
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Provider Business Mailing Address
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Address Line | 28241 CROWN VALLEY PKWY # F465
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-4441
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Country | US
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Telephone | 714-325-4559
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | A182357
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License Number State | CA
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