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General NPI Number Information
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NPI Number | 1912353525
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Entity Type | Organization
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Legal Business Name | NIDHI MEHROTRA MD
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 6769 N WILLOW AVE SUITE 101
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City | FRESNO
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State | CA
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Zip | 93710-5900
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Country | US
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Telephone | 559-325-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 6769 N WILLOW AVE SUITE 101
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City | FRESNO
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State | CA
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Zip | 93710-5900
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Country | US
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Telephone | 559-325-2400
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SUMIT VARMA
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Credential |
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Telephone | 559-259-7596
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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 | A72677
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License Number State | CA
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