Organization
EMANATE PAIN MANAGEMENT MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DHARMESH MEHTA MD (CEO)
(909) 689-6090
Entity
Organization
Contact information
Practice address
9120 HAVEN AVE STE 202, RANCHO CUCAMONGA, CA 91730-5413
(909) 803-0647
(626) 608-7322
Mailing address
PO BOX 209, COVINA, CA 91723-0209
(909) 803-0647
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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