Provider Demographics
NPI:1366553430
Name:NALIN J MEHTA MD PC
Entity type:Organization
Organization Name:NALIN J MEHTA MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NALIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-893-5138
Mailing Address - Street 1:274 UNION BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1813
Mailing Address - Country:US
Mailing Address - Phone:303-893-5138
Mailing Address - Fax:303-893-5610
Practice Address - Street 1:274 UNION BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1813
Practice Address - Country:US
Practice Address - Phone:303-893-5138
Practice Address - Fax:303-893-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32511207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC500958Medicare PIN