Individual
PARAG MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1294 W 6TH STREET, SUITE 105, SAN PEDRO, CA 90731-2997
(310) 521-5990
(310) 521-5991
Mailing address
1294 W 6TH STREET, SUITE 105, SAN PEDRO, CA 90731-2997
(310) 521-5990
(310) 521-5991
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A50838
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A508380
—
CA
01
—
126390000
US DEPT OF LABOR
—
01
—
130025763
RAILROAD MEDICARE PTAN
CA
01
—
1831164029
NPI
—
01
—
318256
UIN (MEDICARE)
CA
01
—
4515740001
NORIDIAN/DME PTAN
CA
01
—
5422000A508380
B SHIELD
—
Enumeration date
02/21/2006
Last updated
01/28/2016
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