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General NPI Number Information
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NPI Number | 1740575455
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Entity Type | Individual
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Provider Name | DEEPTI K MEHTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 975 SERENO DR
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City | VALLEJO
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State | CA
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Zip | 94589-2441
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Country | US
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Telephone | 707-651-3392
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Fax |
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Provider Business Mailing Address
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Address Line | 688 N RIMSDALE AVE APT 30
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City | COVINA
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State | CA
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Zip | 91722-3544
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Country | US
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Telephone | 517-214-3465
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A117235
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License Number State | CA
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