Provider Demographics
NPI:1205883121
Name:LOHTIA, MEENAL SUNIT (MD)
Entity type:Individual
Prefix:MRS
First Name:MEENAL
Middle Name:SUNIT
Last Name:LOHTIA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4000 CIVIC CENTER DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903
Mailing Address - Country:US
Mailing Address - Phone:415-492-3333
Mailing Address - Fax:415-492-3425
Practice Address - Street 1:4000 CIVIC CENTER DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903
Practice Address - Country:US
Practice Address - Phone:415-492-3333
Practice Address - Fax:415-492-3425
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2010-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA93125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH87010Medicare UPIN