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Organization
PRANAV R. MEHTA, M.D., INC.
Active
Organization
PRANAV R. MEHTA, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRANAV RAGHUVIR MEHTA M.D. (PRESIDENT)
(909) 797-5101
Entity
Organization
Contact information
Practice address
12047 4TH ST, YUCAIPA, CA 92399-2735
(909) 797-5101
(909) 797-5103
Mailing address
12047 4TH ST, YUCAIPA, CA 92399-2735
(909) 797-5101
(909) 797-5103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G078698
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G786980
—
CA
01
—
080160338
RR MEDICARE
CA
Enumeration date
11/02/2007
Last updated
05/19/2008
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