Individual
VISHAL KUMAR MITTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
580 DODY DR, MANTECA, CA 95337-8712
(209) 607-8487
Mailing address
580 DODY DR, MANTECA, CA 95337-8712
(209) 607-8487
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95027474
CA
363LA2200X
Adult Health Nurse Practitioner
95027474
CA
363LF0000X
Family Nurse Practitioner
95027474
CA
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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