Provider Demographics
NPI:1922460047
Name:CHIRAG P. MEHTA, MD INC.
Entity Type:Organization
Organization Name:CHIRAG P. MEHTA, MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIRAG
Authorized Official - Middle Name:P
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-338-0911
Mailing Address - Street 1:12760 HESPERIA RD STE C
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8305
Mailing Address - Country:US
Mailing Address - Phone:760-338-0911
Mailing Address - Fax:760-243-0471
Practice Address - Street 1:12760 HESPERIA RD STE C
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8305
Practice Address - Country:US
Practice Address - Phone:760-338-0911
Practice Address - Fax:760-243-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty