Provider Demographics
NPI:1801092705
Name:MEHMI, INDERJIT (MD)
Entity type:Individual
Prefix:DR
First Name:INDERJIT
Middle Name:
Last Name:MEHMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506
Mailing Address - Country:US
Mailing Address - Phone:304-293-4229
Mailing Address - Fax:
Practice Address - Street 1:11800 WILSHIRE BLVD FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6602
Practice Address - Country:US
Practice Address - Phone:310-231-2121
Practice Address - Fax:310-582-7996
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070849A207R00000X
WV24937207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810024009Medicaid
CAA147630OtherTHE MEDICAL BOARD OF CALIFORNIA