Provider Demographics
NPI:1407099799
Name:MEHTA, HIRSCH S (MD)
Entity Type:Individual
Prefix:DR
First Name:HIRSCH
Middle Name:S
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3131 BERGER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4203
Mailing Address - Country:US
Mailing Address - Phone:858-244-6800
Mailing Address - Fax:858-244-6809
Practice Address - Street 1:3131 BERGER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4203
Practice Address - Country:US
Practice Address - Phone:858-244-6800
Practice Address - Fax:858-244-6809
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2021-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA105910207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1407099799Medicaid
CA1407099799Medicaid