Provider Demographics
NPI:1518285360
Name:MENGHANI, RAVI (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:
Last Name:MENGHANI
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 PALO VERDE AVE
Mailing Address - Street 2:SUITE #210
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3445
Mailing Address - Country:US
Mailing Address - Phone:562-297-0880
Mailing Address - Fax:877-205-9923
Practice Address - Street 1:1945 PALO VERDE AVE
Practice Address - Street 2:SUITE #210
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3445
Practice Address - Country:US
Practice Address - Phone:562-297-0880
Practice Address - Fax:877-205-9923
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115755207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology