Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 125599 | CA |
NPI | 1033433776 |
---|---|
Provider Name | Dr. Vivek Mehta |
First Address | Los Angeles, CA 90033-1029 |
Second Address | Los Angeles, CA 90033-1029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2010 |
Last Update Date | 30/09/2014 |