Provider Demographics
NPI:1952477200
Name:MEHIGAN, JOHN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:MEHIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:39141 CIVIC CENTER DR
Mailing Address - Street 2:335
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-5818
Mailing Address - Country:US
Mailing Address - Phone:510-791-1005
Mailing Address - Fax:510-791-2874
Practice Address - Street 1:39141 CIVIC CENTER DR
Practice Address - Street 2:335
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-5818
Practice Address - Country:US
Practice Address - Phone:510-791-1005
Practice Address - Fax:510-791-2874
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG161962086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39730Medicare UPIN
CA00G161961Medicare PIN