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NPI Code Detail

MEDICARE: HA MISTRY M.D.

MEDICARE: HA MISTRY 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
12084P0800XPsychiatry PhysicianA93547CA

General Provider Information

NPI Number : 1619941820
Entity Type Code : Individual
Provider Name (Legal Business Name) : HA MISTRY M.D.
Provider Business Mailing Address
First Line : 1630 E MAIN ST
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5204
Country : US
Telephone Number : 619-563-5300
Fax Number :
Provider Business Practice Location Address
First Line : 1630 E MAIN ST
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5204
Country : US
Telephone Number : 619-563-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 12/03/2021

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