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General NPI Number Information
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NPI Number | 1710007786
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Entity Type | Organization
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Legal Business Name | KHUSAL MEHTA RURAL HEALTH CLINIC
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Dates
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Enumeration Date | 03/31/2007
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 430 N VERMONT AVE
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City | DINUBA
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State | CA
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Zip | 93618-1631
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Country | US
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Telephone | 559-591-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 430 N VERMONT AVE
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City | DINUBA
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State | CA
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Zip | 93618-1631
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Country | US
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Telephone | 559-591-1060
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. KHUSAL D MEHTA
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Credential | M.D.
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Telephone | 559-591-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 0A360470
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License Number State | CA
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