Provider Demographics
NPI:1841999711
Name:MEHRA CLINIC, PLLC
Entity type:Organization
Organization Name:MEHRA CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RINKU
Authorized Official - Middle Name:MEHRA
Authorized Official - Last Name:SANDESARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-940-0635
Mailing Address - Street 1:8230 BOONE BLVD STE 170
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2621
Mailing Address - Country:US
Mailing Address - Phone:703-940-0632
Mailing Address - Fax:703-952-7685
Practice Address - Street 1:8230 BOONE BLVD STE 170
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2621
Practice Address - Country:US
Practice Address - Phone:703-940-0632
Practice Address - Fax:703-952-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty