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General NPI Number Information
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NPI Number | 1578502159
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Entity Type | Individual
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Provider Name | NILESH D MEHTA MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 14200 W CELEBRATE LIFE WAY
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City | GOODYEAR
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State | AZ
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Zip | 85338-3007
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Country | US
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Telephone | 800-322-9183
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Fax |
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Provider Business Mailing Address
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Address Line | 6897 PAYSPHERE CIRCLE
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City | CHICAGO
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State | IL
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Zip | 60674-0001
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Country | US
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Telephone | 800-294-8333
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Fax | 847-746-4499
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 036.077916
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 64889
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License Number State | AZ
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