Pratik D Mehta, MD | |
120 Mayfair, Aliso Viejo, CA 92656-2832 | |
(949) 357-7142 | |
(209) 468-7042 |
Full Name | Pratik D Mehta |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 120 Mayfair, Aliso Viejo, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063853919 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | A139446 (California) | Primary |
Entity Name | Faculty Physicians And Surgeons Of Llusm |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
Entity Name | County Of San Joaquin |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801830583 PECOS PAC ID: 6002703436 Enrollment ID: O20040301001287 |
Entity Name | Riverside Medical Clinic Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720183403 PECOS PAC ID: 2961492327 Enrollment ID: O20040517000880 |
Entity Name | San Joaquin Faculty Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225063761 PECOS PAC ID: 4082631395 Enrollment ID: O20051026000742 |
Entity Name | Faculty Physicians And Surgeons Of Llusm |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508255175 PECOS PAC ID: 1153227814 Enrollment ID: O20160216002196 |
Mailing Address | Practice Location Address |
---|---|
Pratik D Mehta, MD 120 Mayfair, Aliso Viejo, CA 92656-2832 Ph: (949) 357-7142 | Pratik D Mehta, MD 120 Mayfair, Aliso Viejo, CA 92656-2832 Ph: (949) 357-7142 |