Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A173315 | CA |
NPI | 1578982880 |
---|---|
Provider Name | Shailja Mehta |
First Address | Los Altos, CA 94022-1408 |
Second Address | San Jose, CA 95124-4100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 09/11/2021 |