MEDICARE: CHANDRAKANT V MEHTA M.D.

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
1	174400000X	Specialist	A37044	CA

General Provider Information

NPI Number	:	1326093402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDRAKANT V MEHTA M.D.

Provider Business Mailing Address
First Line	:	949 CALHOUN PL
Second Line	:	SUITE F
City	:	HEMET
State	:	CA
Zip	:	92543-4403
Country	:	US
Telephone Number	:	951-652-5000
Fax Number	:	951-765-6688

Provider Business Practice Location Address
First Line	:	949 CALHOUN PL
Second Line	:	SUITE F
City	:	HEMET
State	:	CA
Zip	:	92543-4403
Country	:	US
Telephone Number	:	951-652-5000
Fax Number	:	951-765-6688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	02/22/2008

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