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NPI Code Detail

MEDICARE: TANVI MEHTA PT, DPT

MEDICARE:   TANVI  MEHTA  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical Therapist40871CA

General Provider Information

NPI Number : 1104257401
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANVI MEHTA PT, DPT
Provider Business Mailing Address
First Line : 11134 PIONEER BLVD
Second Line :
City : NORWALK
State : CA
Zip : 90650-1680
Country : US
Telephone Number : 714-220-7992
Fax Number :
Provider Business Practice Location Address
First Line : 6820 S CENTINELA AVE
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6301
Country : US
Telephone Number : 714-220-7992
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2013
Last Update Date : 12/12/2013

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