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General NPI Number Information
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NPI Number | 1174807994
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Entity Type | Individual
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Provider Name | RAVI M MEHTA MD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | VAIC- VISALIA ADULT INTEGRATIVE CLINIC 520 E TULARE AVE
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City | VISALIA
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State | CA
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Zip | 93292
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Country | US
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Telephone | 559-602-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 10012 E 83RD ST
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-960-1733
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E-5177
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 19229
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A62806
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License Number State | CA
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