Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A93336 | CA |
NPI | 1245393586 |
---|---|
Provider Name | Dr. Ritvik Prakash Mehta |
First Address | Carlsbad, CA 92008-7216 |
Second Address | Carlsbad, CA 92008-7216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 14/04/2019 |