Provider Demographics
NPI:1366864878
Name:MEHTA, TRUSHA (PT)
Entity Type:Individual
Prefix:
First Name:TRUSHA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 W MISSION BLVD
Mailing Address - Street 2:110-397
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1711
Mailing Address - Country:US
Mailing Address - Phone:909-730-7088
Mailing Address - Fax:909-620-9800
Practice Address - Street 1:312 W CERRITOS AVE
Practice Address - Street 2:BLDG. 7
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6550
Practice Address - Country:US
Practice Address - Phone:714-947-1215
Practice Address - Fax:714-947-1215
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
225100000X
CA40700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist