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General NPI Number Information
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NPI Number | 1295187060
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Entity Type | Organization
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Legal Business Name | PAMELA MEHTA MD INC
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 2242 CAMDEN AVE SUITE 104
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City | SAN JOSE
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State | CA
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Zip | 95124-2029
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Country | US
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Telephone | 415-871-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 WILLOW ST SUITE 3-110
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City | SAN JOSE
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State | CA
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Zip | 95125-2350
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Country | US
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Telephone | 415-871-5520
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAMELA MEHTA
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Credential | MD
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Telephone | 415-871-5520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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