Provider Demographics
NPI:1841571411
Name:MEHTA, PAMELA (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3043 MERIDIAN AVE STE 39
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2455
Mailing Address - Country:US
Mailing Address - Phone:408-471-7138
Mailing Address - Fax:408-317-0600
Practice Address - Street 1:2430 SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3907
Practice Address - Country:US
Practice Address - Phone:408-471-7138
Practice Address - Fax:408-317-0600
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA116839207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery