Provider Demographics
NPI:1558344416
Name:MITTAL, SHEILAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILAJA
Middle Name:
Last Name:MITTAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 S MAIN ST # 380
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2204
Mailing Address - Country:US
Mailing Address - Phone:831-422-3701
Mailing Address - Fax:831-536-1691
Practice Address - Street 1:680 E. ROMIE LANE, STE A
Practice Address - Street 2:WORKWELL HEALTH SERVICES
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-422-3701
Practice Address - Fax:831-422-3751
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A765690Medicare ID - Type Unspecified
CAG42405Medicare UPIN