Provider Demographics
NPI:1497289789
Name:MEHUL RAVAL
Entity Type:Organization
Organization Name:MEHUL RAVAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MEHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-546-1868
Mailing Address - Street 1:1801 EACH MARCH LANE
Mailing Address - Street 2:SUITE B265
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-6655
Mailing Address - Country:US
Mailing Address - Phone:209-546-1868
Mailing Address - Fax:209-461-6505
Practice Address - Street 1:1801 EACH MARCH LANE
Practice Address - Street 2:SUITE B265
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-6655
Practice Address - Country:US
Practice Address - Phone:209-546-1868
Practice Address - Fax:209-461-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty