Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 267275 | NY |
N | 208200000X | Surgeon | 233712 | MA |
N | 208600000X | Surgeon | 233712 | MA |
Y | 208200000X | Surgeon | A123128 | CA |
Y | 208600000X | Surgeon | A123128 | CA |
NPI | 1356541338 |
---|---|
Provider Name | Raj Mittal |
First Address | Torrance, CA 90505-4980 |
Second Address | Torrance, CA 90505-4980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 28/04/2020 |