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General NPI Number Information
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NPI Number | 1275827636
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Entity Type | Individual
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Provider Name | MIHIR KISHOR SANGHVI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 5155 SEAGREEN CT
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2637
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Country | US
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Telephone | 951-323-5598
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Fax |
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Provider Business Mailing Address
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Address Line | 12223 HIGHLAND AVE SUITE 106-804
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2574
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Country | US
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Telephone | 951-323-5598
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Fax | 909-292-4546
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A115171
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License Number State | CA
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