Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | A47851 | CA |
Y | 207RI0011X | Interventional Cardiology | A47851 | CA |
NPI | 1104895739 |
---|---|
Provider Name | Dr. Viral Mehta |
First Address | Bakersfield, CA 93309-0610 |
Second Address | Bakersfield, CA 93309-0610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 02/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A478510 | BLUE SHIELD (01) | |
00A478511 | (05) | CA |
060051588 | MEDICARE RAILROAD (01) | |
F11735 | (02) |