Provider Demographics
NPI:1992901540
Name:MEHTA, NAGIN G (MD)
Entity type:Individual
Prefix:DR
First Name:NAGIN
Middle Name:G
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7519
Mailing Address - Country:US
Mailing Address - Phone:408-946-4800
Mailing Address - Fax:
Practice Address - Street 1:791 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7519
Practice Address - Country:US
Practice Address - Phone:408-946-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACFE51504208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY290971Medicare ID - Type Unspecified
NYE 61174Medicare UPIN