Provider Demographics
NPI:1033665252
Name:MIHIR K. SANGHVI, M.D., INC.
Entity Type:Organization
Organization Name:MIHIR K. SANGHVI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGHVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-323-5598
Mailing Address - Street 1:12223 HIGHLAND AVE
Mailing Address - Street 2:SUITE 106-804
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-2574
Mailing Address - Country:US
Mailing Address - Phone:951-323-5598
Mailing Address - Fax:909-292-4546
Practice Address - Street 1:5155 SEAGREEN CT
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-2637
Practice Address - Country:US
Practice Address - Phone:951-323-5598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115171207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty