Provider Demographics
NPI:1740141654
Name:SUKRANT MEHTA, MD PC
Entity type:Organization
Organization Name:SUKRANT MEHTA, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUKRANT
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-299-0187
Mailing Address - Street 1:9903 STA MONICA BLVD # 208
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1606
Mailing Address - Country:US
Mailing Address - Phone:310-299-0187
Mailing Address - Fax:310-579-4992
Practice Address - Street 1:450 N ROXBURY DR STE 101
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4209
Practice Address - Country:US
Practice Address - Phone:310-299-0187
Practice Address - Fax:310-579-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty