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General NPI Number Information
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NPI Number | 1386761617
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Entity Type | Organization
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Legal Business Name | C.V.MEHTA MD A MEDICAL CORP.
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 949 CALHOUN PL SUITE F
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City | HEMET
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State | CA
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Zip | 92543-4403
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Country | US
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Telephone | 951-652-5000
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Fax | 951-765-6688
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Provider Business Mailing Address
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Address Line | 949 CALHOUN PL SUITE F
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City | HEMET
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State | CA
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Zip | 92543-4403
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Country | US
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Telephone | 951-652-5000
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Fax | 951-765-6688
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DENI C MEHTA
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Credential | B.A.
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Telephone | 951-652-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 00A370440
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License Number State | CA
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