Provider Demographics
NPI:1710157474
Name:RAVAL, MEHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHUL
Middle Name:
Last Name:RAVAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1801 E MARCH LN STE B265
Mailing Address - Street 2:
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 E MARCH LN STE B265
Practice Address - Street 2:
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
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-08
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA105804207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology